Provider Demographics
NPI:1871875864
Name:THOMAS, KRISTEN MURTHA
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:MURTHA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4667 WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-2005
Mailing Address - Country:US
Mailing Address - Phone:724-325-3478
Mailing Address - Fax:724-325-3556
Practice Address - Street 1:4667 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-2005
Practice Address - Country:US
Practice Address - Phone:724-325-3478
Practice Address - Fax:724-325-3556
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444805183500000X
MD20362183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist