Provider Demographics
NPI:1063881183
Name:AUSTIN, KRISTIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:AUSTIN
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 1:314 GOFF MOUNTAIN RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-6602
Mailing Address - Country:US
Mailing Address - Phone:304-388-7054
Mailing Address - Fax:304-388-7055
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-1200
Practice Address - Country:US
Practice Address - Phone:304-598-4148
Practice Address - Fax:304-598-4073
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN121336183500000X
WVRP0009319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist