Individual
KRISTAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD, BCACP
Contact information
Practice address
4901 STATE ROAD 26 E, LAFAYETTE, IN 47905-4611
(765) 449-9210
(765) 449-9265
Mailing address
3600 CASS LN, LAFAYETTE, IN 47909-9331
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
26024031A
IN
Other
Enumeration date
05/08/2014
Last updated
05/08/2014
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