Provider Demographics
NPI:1386928018
Name:BADDERS, KRISTIN M (RPH)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:M
Last Name:BADDERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 BLUEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-5723
Mailing Address - Country:US
Mailing Address - Phone:785-776-9787
Mailing Address - Fax:
Practice Address - Street 1:325 BLUEMONT AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-5723
Practice Address - Country:US
Practice Address - Phone:785-776-9787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-10506183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist