Provider Demographics
NPI:1366727224
Name:SOUKUP, CHRISTINA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:SOUKUP
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 1:2311 RIVER TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-8944
Mailing Address - Country:US
Mailing Address - Phone:620-640-4509
Mailing Address - Fax:785-826-9688
Practice Address - Street 1:700 S BROADWAY BLVD
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4655
Practice Address - Country:US
Practice Address - Phone:785-827-3974
Practice Address - Fax:785-826-9688
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist