Provider Demographics
NPI:1194395079
Name:SKIME, KRISTIN ANN (RPH, PHARMD)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:ANN
Last Name:SKIME
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:MS
Other - First Name:KRISTIN
Other - Middle Name:ANN
Other - Last Name:CROUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 FIRST DR. NW MCHS-AUSTIN CLINIC PHARMACY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:MN
Mailing Address - Zip Code:55912
Mailing Address - Country:US
Mailing Address - Phone:507-434-1422
Mailing Address - Fax:
Practice Address - Street 1:1000 FIRST DR. NW MCHS-AUSTIN CLINIC PHARMACY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912
Practice Address - Country:US
Practice Address - Phone:507-434-1422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN125036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist