Krystal Annette Reagan, PHARMD
Individual provider Active NPI Pharmacist · Friendsville, TN
NPI 1740967439 · NPPES record last updated Jul 3, 2023
Key facts
- NPI
- 1740967439
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 47260 (TN)
- Practice address
- 4815 Big Springs Rd
Friendsville, TN 37737-2929 - Phone
- (304) 784-0116
- NPI assigned
- Jul 3, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47260 | TN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 47260 | TN | Yes |
Addresses
Primary practice location
4815 Big Springs Rd
Friendsville, TN 37737-2929
Mailing address
4815 Big Springs Rd
Friendsville, TN 37737-2929
Phone (304) 784-0116
Other providers in Friendsville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.