Provider Demographics
NPI:1588951511
Name:STONE, KRISTINE DIANE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:DIANE
Last Name:STONE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3629
Mailing Address - Country:US
Mailing Address - Phone:207-945-9977
Mailing Address - Fax:207-945-9977
Practice Address - Street 1:60 LONGVIEW DR
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3629
Practice Address - Country:US
Practice Address - Phone:207-945-9977
Practice Address - Fax:207-945-9977
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5569183500000X
MA26562183500000X
RI04540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist