Individual
MS. KRISTIN RENEE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
1650 COCHRANE CIRCLE, OUTPATIENT PHARMACY, FORT CARSON, CO 80913
(719) 524-4410
Mailing address
1485 SOLITAIRE ST, COLORADO SPRINGS, CO 80905-4255
(805) 717-3743
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16808
CO
Other
Enumeration date
11/11/2011
Last updated
08/28/2025
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