Basic Information
Provider Information
NPI: 1396751442
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KLINGER
FirstName: KRISTY
MiddleName: M.
NamePrefix: MS.
NameSuffix:  
Credential: PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 680
Address2: 503 W. COMANCHE DR.
City: WHITERIVER
State: AZ
PostalCode: 859410680
CountryCode: US
TelephoneNumber: 9283383504
FaxNumber: 9283383510
Practice Location
Address1: 200 WEST HOSPITAL DR.
Address2:  
City: WHITERIVER
State: AZ
PostalCode: 85941
CountryCode: US
TelephoneNumber: 9283383504
FaxNumber: 9283383510
Other Information
ProviderEnumerationDate: 07/31/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000XRP044505LPAN Pharmacy Service ProvidersPharmacist 
183500000X15059AZY Pharmacy Service ProvidersPharmacist 

No ID Information.


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