Kriste Charlene Hollenbaugh, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302028818 Issued in MI

Practice address

1750 Gratiot Blvd
Marysville, MI 48040

Phone

(810) 364-6200

Fax

(810) 364-3084

NPI assigned

Mar 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Kriste Charlene Ruble Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404259200000",
    "number": "1861522666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 GRATIOT BLVD",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "48040",
            "telephone_number": "810-364-6200",
            "fax_number": "810-364-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 GRATIOT BLVD",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "48040",
            "telephone_number": "810-364-6200",
            "fax_number": "810-364-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLENBAUGH",
        "first_name": "KRISTE",
        "middle_name": "CHARLENE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2014-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302028818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RPH LISCENCE NUMBER",
            "identifier": "5302028818",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTE",
            "last_name": "RUBLE",
            "middle_name": "CHARLENE",
            "prefix": "MISS",
            "credential": "RPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pharmacist in Marysville, MI
• Providers in Marysville, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.