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General NPI Number Information
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NPI Number | 1477025443
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Entity Type | Individual
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Provider Name | KRISTIN CHARLENE FERRIS-THOMPSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/01/2019
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Last Update Date | 01/01/2019
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Provider Practice Location Address
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Address Line | 404 W FOUNTAIN ST
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City | ALBERT LEA
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State | MN
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Zip | 56007-2437
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Country | US
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Telephone | 507-377-6205
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Fax |
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Provider Business Mailing Address
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Address Line | 28170 785TH AVE
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City | CLARKS GROVE
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State | MN
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Zip | 56016-4096
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Country | US
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Telephone | 507-383-7497
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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 | 117515
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License Number State | MN
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