1013021609 NPI number — KRISTINA BALLINGER COHEN PHARMD

Table of content: KRISTINA BALLINGER COHEN PHARMD (NPI 1013021609)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013021609 NPI number — KRISTINA BALLINGER COHEN PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COHEN
Provider First Name:
KRISTINA
Provider Middle Name:
BALLINGER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BALLINGER
Provider Other First Name:
KRISTINA
Provider Other Middle Name:
JOY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1013021609
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3061 BRIDLE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANCHORAGE
Provider Business Mailing Address State Name:
AK
Provider Business Mailing Address Postal Code:
99517-1413
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
907-677-2958
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4320 DIPLOMACY DR
Provider Second Line Business Practice Location Address:
ANMC PRIMARY CARE CENTER PHARMACY
Provider Business Practice Location Address City Name:
ANCHORAGE
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99508-5925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-729-8874
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/19/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  2988 , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 183500000X , with the licence number: 1737 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)