KRISTIN CAMPBELL MAHAN (NPI# 1265662027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265662027 |
| Entity Type | Individual |
| Full Name | KRISTIN CAMPBELL MAHAN |
| Credential | PHARM.D. |
| Practice Address |
1031 Bellevue Ave Ste 300 Saint Louis MO 63117-1857 |
| Mailing Address |
1031 Bellevue Ave Ste 300 Saint Louis MO 63117-1818 |
| Practice Telephone | 3146464225 |
| Mailing Telephone | 3145605315 |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2017-01-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
2009016877 | MO | Pharmacy Service Providers |
| N | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
1-14405 | KS | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750663860 | Kristin Marie Mahan | Nurse Practitioner | 28 Harris Fuller Rd, Preston, CT 06365-8201 | 2011-09-14 |
| 1891203709 | Kristin Mahan | Developmental Therapist | 345a Greenwood St Ste B, Worcester, MA 01607-1753 | 2018-01-12 |
| 1366610917 | Kristin Mahan | Speech-Language Pathologist | 9 Lacrue Ave, Glen Mills, PA 19342-1062 | 2008-02-18 |
| 1487622957 | Kristin A Mahan | Family Medicine | 406 N 1st St, Vincennes, IN 47591-1340 | 2006-03-10 |
| Street Address |
1031 BELLEVUE AVE STE 300 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63117-1857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952867731 | Alexa Evie Naceanceno | Physician Assistant | 1031 Bellevue Ave Ste 300, Saint Louis, MO 63117-1857 | 2019-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
| 1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
| 1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
| 1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
| 1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
| 1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
| 1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
| 1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
| 1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
| 1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
| Find all providers in zip 63117 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942682604 | Shane Austin | Pharmacist | 8660 Old Bonhomme Rd Apt B, Saint Louis, MO 63132-3936 | 2015-06-18 |
| 1740537554 | Stephanie Michelle Crist | Pharmacist | 520 Maryville Centre Dr Ste 500, Saint Louis, MO 63141-5840 | 2012-08-10 |
| 1477829406 | Albert Zvibleman | Pharmacist | 1830 Pickfair Dr, Saint Louis, MO 63146-3626 | 2012-03-23 |
| 1386890127 | Jamie Reski | Pharmacist | 1800 S Brentwood Blvd Apt 10212, Saint Louis, MO 63144-1860 | 2008-08-12 |
| 1275170128 | Holly Przygoda | Pharmacist | 5055 Arsenal St, Saint Louis, MO 63139-1011 | 2019-12-10 |
| 1366099178 | Melissa Ann Stutz | Pharmacist | 6600 Clayton Rd, Saint Louis, MO 63117-1602 | 2019-08-26 |
| 1679129597 | Scott Boyle | Pharmacist | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2019-08-15 |
| 1588221113 | Rebecca Brand | Pharmacist | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2019-05-20 |
| 1194388405 | Madeline C Normansell | Pharmacist | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2019-04-22 |
| 1164984886 | Nausheen Hasan | Pharmacist | 1 Childrens Pl, Saint Louis, MO 63110-1002 | 2019-04-02 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63117 |
Please comment or provide details below to improve the information on KRISTIN CAMPBELL MAHAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.