Provider Demographics
NPI:1427349125
Name:KISSLING, KRISTEN (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:KISSLING
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:SALETRIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:36298 MONTROSE WAY
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-3494
Mailing Address - Country:US
Mailing Address - Phone:440-476-1568
Mailing Address - Fax:
Practice Address - Street 1:4510 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5757
Practice Address - Country:US
Practice Address - Phone:216-765-2809
Practice Address - Fax:216-201-5516
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03129435183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist