MEDICARE: DR. KRISTEN ANNE NICOLE DRIVER 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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	16790	NE

General Provider Information

NPI Number	:	1639818628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTEN ANNE NICOLE DRIVER PHARMD

Provider Business Mailing Address
First Line	:	2402 UNIVERSITY DRIVE
Second Line	:
City	:	KEARNEY
State	:	NE
Zip	:	68849-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2402 UNIVERSITY DRIVE
Second Line	:
City	:	KEARNEY
State	:	NE
Zip	:	68849-0001
Country	:	US
Telephone Number	:	111-111-1111
Fax Number	:

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

Provider Enumeration Date	:	05/31/2022
Last Update Date	:	05/13/2025

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