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NPI Code Detail

MEDICARE: KRISTINE GRAHAM PHARMD

MEDICARE: KRISTINE GRAHAM 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
1183500000XPharmacist03230305OH

General Provider Information

NPI Number : 1700189230
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINE GRAHAM PHARMD
Provider Business Mailing Address
First Line : 650 JOEL DR
Second Line :
City : FORT CAMPBELL
State : KY
Zip : 42223-5318
Country : US
Telephone Number : 270-798-8400
Fax Number :
Provider Business Practice Location Address
First Line : 650 JOEL DR
Second Line :
City : FORT CAMPBELL
State : KY
Zip : 42223-5318
Country : US
Telephone Number : 270-798-8400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2010
Last Update Date : 01/28/2026

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Directions to “ KRISTINE GRAHAM PHARMD” Practice Location

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