DR. KRISTAIN BRADLEY DEDMON (NPI# 1366726937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366726937 |
| Entity Type | Individual |
| Full Name | DR. KRISTAIN BRADLEY DEDMON |
| Credential | PHARM.D. |
| Practice Address |
108 E Highland Dr Jonesboro AR 72401-5940 |
| Practice Telephone | 8708023749 |
| Practice Fax Number | 8708022372 |
| Mailing Telephone | 8708023749 |
| Mailing Fax Number | 8708022372 |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2011-09-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 33841 | TN | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | PD11142 | AR | Pharmacy Service Providers |
| Street Address |
108 E HIGHLAND DR |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401-5940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093720351 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 108 E Highland Dr, Jonesboro, AR 72401-5940 | 2006-07-29 |
| 1265047542 | Amanda Lynne Higgins | Pharmacist | 108 E Highland Dr, Jonesboro, AR 72401-5940 | 2020-09-13 |
| 1568905495 | Kisito N Kikam | Pharmacist | 108 E Highland Dr, Jonesboro, AR 72401-5940 | 2016-11-26 |
| 1437533544 | Wendy Jordan | Pharmacist | 108 E Highland Dr, Jonesboro, AR 72401-5940 | 2015-07-17 |
| 1093199929 | Sarah Newberry | Pharmacist | 108 E Highland Dr, Jonesboro, AR 72401-5940 | 2015-07-09 |
| 1700269818 | Jessica Bullington | Pharmacist | 108 E Highland Dr, Jonesboro, AR 72401-5940 | 2015-07-07 |
| 1043628076 | Deborah Liles | Pharmacist | 108 E Highland Dr, Jonesboro, AR 72401-5940 | 2014-07-22 |
| 1912349325 | Andrew Ford | Pharmacist | 108 E Highland Dr, Jonesboro, AR 72401-5940 | 2013-07-26 |
| 1265718126 | Krissy Canada | Pharmacist | 108 E Highland Dr, Jonesboro, AR 72401-5940 | 2011-10-24 |
| 1437434560 | Brandi Barrett Garrison | Pharmacist | 108 E Highland Dr, Jonesboro, AR 72401-5940 | 2011-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689219 | Olubunmi Adeniyi | Pharmacist | 524 Serene Waters Trl, Jonesboro, GA 30236-5495 | 2020-11-03 |
| 1811493877 | James Blake Richardson | Pharmacist | 1112 Windover Rd, Jonesboro, AR 72401-6038 | 2018-03-30 |
| 1942727730 | Tyler Alan Soo | Pharmacist | 2822 East Nettleton Avenue, Jonesboro, AR 72401 | 2017-08-23 |
| 1972954550 | Purvis Glen Nash | Pharmacist | 700 Holley Dr, Jonesboro, LA 71251-3021 | 2016-06-25 |
| 1295195949 | Daniel James Irwin | Pharmacist | 6424 County Road 333, Jonesboro, AR 72401-0364 | 2016-02-23 |
| 1790155661 | Shewanda L Vines | Pharmacist | 7267 Tara Blvd, Jonesboro, GA 30236-1901 | 2015-10-04 |
| 1679978043 | Kristy Reed | Pharmacist | 1000-a East Matthews Ave., Jonesboro, AR 72401 | 2014-10-28 |
| 1750786257 | Melanie Weathers | Pharmacist | 1000 E Matthews Ave Ste A, Jonesboro, AR 72401-4344 | 2014-10-27 |
| 1588006167 | Mallory Morgan | Pharmacist | 2015 Harwood Dr, Jonesboro, AR 72404-9100 | 2013-07-23 |
| 1053751784 | Benjamin Brent Washam | Pharmacist | 992 Links Dr Apt 8, Jonesboro, AR 72404-0791 | 2013-06-26 |
| Find all providers in JONESBORO | ||||
Please comment or provide details below to improve the information on DR. KRISTAIN BRADLEY DEDMON.
| 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.