Provider Demographics
NPI:1174402044
Name:LISTON, KRISTEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:LISTON
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 1:508 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:IL
Mailing Address - Zip Code:62016-1027
Mailing Address - Country:US
Mailing Address - Phone:217-942-1111
Mailing Address - Fax:
Practice Address - Street 1:508 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:IL
Practice Address - Zip Code:62016-1027
Practice Address - Country:US
Practice Address - Phone:217-942-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.295859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist