Provider Demographics
NPI:1043241227
Name:HUMBER, KRISTY (RPH)
Entity type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:
Last Name:HUMBER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 5TH ST N
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-2211
Mailing Address - Country:US
Mailing Address - Phone:662-240-8900
Mailing Address - Fax:662-240-8966
Practice Address - Street 1:2211 5TH ST N
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-2211
Practice Address - Country:US
Practice Address - Phone:662-240-8900
Practice Address - Fax:662-240-8966
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE08683183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist