Individual
KRISTEN PACKARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1151 STONECREST BLVD, TEGA CAY, SC 29708-6555
(803) 578-4120
Mailing address
1151 STONECREST BLVD, TEGA CAY, SC 29708-6555
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12417
SC
183500000X
Pharmacist
20278
NC
183500000X
Pharmacist
AR07978
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12417
PHARMACY LICENSE
SC
Enumeration date
04/24/2014
Last updated
04/24/2014
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