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General NPI Number Information
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NPI Number | 1235789736
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Entity Type | Individual
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Provider Name | KRISTEN CHARITY LEE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/17/2019
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 655 W 8TH ST # C23
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6511
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Country | US
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Telephone | 904-844-7973
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Fax |
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Provider Business Mailing Address
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Address Line | 2163 POST ST APT 2
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City | JACKSONVILLE
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State | FL
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Zip | 32204-3725
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Country | US
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Telephone | 386-690-9770
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS53128
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License Number State | FL
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