Provider Demographics
NPI:1972818979
Name:DYER, KRISTEN FINNEY (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:FINNEY
Last Name:DYER
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 1:3304 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-7308
Mailing Address - Country:US
Mailing Address - Phone:318-651-9171
Mailing Address - Fax:
Practice Address - Street 1:3304 CYPRESS ST
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-7308
Practice Address - Country:US
Practice Address - Phone:318-651-9171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist