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General NPI Number Information
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NPI Number | 1932097722
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Entity Type | Individual
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Provider Name | KRISTIN WHEELER RPH
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Gender | Female
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Dates
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Enumeration Date | 06/27/2025
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 907 E HIGHWAY 50
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City | O FALLON
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State | IL
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Zip | 62269-2856
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Country | US
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Telephone | 618-632-9873
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Fax |
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Provider Business Mailing Address
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Address Line | 9515 FIELDCREST PL
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City | BREESE
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State | IL
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Zip | 62230-0015
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Country | US
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Telephone | 314-330-3092
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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 | 051.290987
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License Number State | IL
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