Individual provider Active NPI

Kristen Gustafsson, PHARMD

  • Pharmacist
  • Brunswick, GA
National Provider Identifier
1073031688
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH029916 Issued in GA
Practice address
171 Village at Glynn PL Ste 100
Brunswick, GA 31525-1988
Phone
(912) 261-4734
NPI assigned
Sep 4, 2017
Last updated
May 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH029916 GA Primary

Addresses

Primary practice location

171 Village at Glynn PL Ste 100
Brunswick, GA 31525-1988

Mailing address

512 Conservation Dr
Saint Simons Island, GA 31522-1135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH029916GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Super Markets Inc PastSince Oct 6, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1504483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1073031688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 CONSERVATION DR",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315221135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 VILLAGE AT GLYNN PL STE 100",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315251988",
            "telephone_number": "912-261-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSSON",
        "first_name": "KRISTEN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-04",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH029916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.