Wallace, Kristie Jackson

Wallace, Kristie Jackson is an individual health care provider with primary practice located at 499 Laguna Dr , St Petersburg FL 33715-1842. She recently has only one registered license in Pharmacy Service Providers / Pharmacotherapy, which is considered as her primary health care specialty. Wallace, Kristie Jackson can be contacted via phone (727) 542-1340.

Contact Information

Primary practice address

499 Laguna Dr St Petersburg FL 33715-1842

Phone: (727) 542-1340

Fax: (727) 865-6040

Website:

Map and Directions

Health care specialties

Specialty	Code	License #	State
Pharmacy Service Providers / Pharmacotherapy	1835P1200X	PS27159	Florida

Profile Details

NPI number	1154324861
LBN Legal business name	Wallace, Kristie Jackson
Credentials	PHARMD
Entity	Individual
Sole proprietor ¹	No
Enumeration date	May 27th, 2005
Last updated	Jul 8th, 2007 - about 18 years ago

¹ A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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