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General NPI Number Information
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NPI Number | 1215938345
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Entity Type | Individual
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Provider Name | KRISTINE HAGEE CPHT
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Gender | Female
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 MEDICAL PARK BLVD SUITE 106-E
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City | BRISTOL
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State | TN
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Zip | 37620-7430
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Country | US
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Telephone | 423-844-2890
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Fax | 423-844-2894
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Provider Business Mailing Address
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Address Line | 208 EASTSIDE DR
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City | BRISTOL
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State | TN
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Zip | 37620-4910
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Country | US
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Telephone | 423-274-0210
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 1901-0297-2009-685
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License Number State | TN
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