Provider Demographics
NPI:1043764442
Name:FOOTE, KRISTY JANE (PHARMD)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:JANE
Last Name:FOOTE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5720 E HORSESHOE RD
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-2249
Mailing Address - Country:US
Mailing Address - Phone:480-861-9419
Mailing Address - Fax:
Practice Address - Street 1:23215 N PIMA RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4315
Practice Address - Country:US
Practice Address - Phone:480-473-2711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS022057183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist