Provider Demographics
NPI:1003829011
Name:WILLIAMS, CARRIE LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-2867
Mailing Address - Country:US
Mailing Address - Phone:785-749-2311
Mailing Address - Fax:
Practice Address - Street 1:2336 RIDGE CT
Practice Address - Street 2:STE C
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046-3983
Practice Address - Country:US
Practice Address - Phone:785-841-1950
Practice Address - Fax:785-841-1051
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-12914183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1-12914OtherSTATE PHARMACY LICENSE