MEDICARE: DR. KIRSTEN CELESTE TOBBE PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	26023247A	IN
2	183500000X	Pharmacist	014596	KY

General Provider Information

NPI Number	:	1437431145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIRSTEN CELESTE TOBBE PHARMD

Provider Business Mailing Address
First Line	:	934 SPRING ST
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-3639
Country	:	US
Telephone Number	:	812-283-1384
Fax Number	:	812-285-0288

Provider Business Practice Location Address
First Line	:	934 SPRING ST
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-3639
Country	:	US
Telephone Number	:	812-283-1384
Fax Number	:	812-285-0288

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2011
Last Update Date	:	09/20/2011

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