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General NPI Number Information
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NPI Number | 1932582095
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Entity Type | Individual
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Provider Name | CHRISTA KLOECKER PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 1624 LASKIN RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-7507
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Country | US
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Telephone | 757-425-9474
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 GUNN HALL DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-5723
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Country | US
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Telephone |
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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 | 0202212821
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License Number State | VA
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