Provider Demographics
NPI:1871946590
Name:POWERS, KRISTEN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4254 NE MEADOW CREEK CIR
Mailing Address - Street 2:APT 306
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-6329
Mailing Address - Country:US
Mailing Address - Phone:417-860-3802
Mailing Address - Fax:
Practice Address - Street 1:4206 W NEW HOPE RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8258
Practice Address - Country:US
Practice Address - Phone:479-621-0958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD13719183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist