Provider Demographics
NPI:1871745331
Name:DUKES, KRISTIN BRAWLEY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:BRAWLEY
Last Name:DUKES
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 1:633 HAMPTON TRACE LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-1937
Mailing Address - Country:US
Mailing Address - Phone:803-776-8278
Mailing Address - Fax:
Practice Address - Street 1:7520 GARNERS FERRY RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-2628
Practice Address - Country:US
Practice Address - Phone:803-783-1589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC011136183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist