Provider Demographics
NPI:1124497839
Name:FRYE, KRISTIN (PHARM D)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:FRYE
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 1:4230 DON KING RD
Mailing Address - Street 2:
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-9047
Mailing Address - Country:US
Mailing Address - Phone:907-247-2183
Mailing Address - Fax:907-247-2187
Practice Address - Street 1:4230 DON KING RD
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-9047
Practice Address - Country:US
Practice Address - Phone:907-247-2183
Practice Address - Fax:907-247-2187
Is Sole Proprietor?:No
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist