Provider Demographics
NPI:1528666906
Name:MORRIS, KRISTINE FOWLER (RPH)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:FOWLER
Last Name:MORRIS
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 1:2600 MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-3925
Mailing Address - Country:US
Mailing Address - Phone:615-382-9844
Mailing Address - Fax:
Practice Address - Street 1:KROGER PHARMACY
Practice Address - Street 2:2600 MEMORIAL BLVD
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172
Practice Address - Country:US
Practice Address - Phone:615-382-9844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7854183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist