Provider Demographics
NPI:1043976087
Name:CARR, GABRIELLA MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:MARIE
Last Name:CARR
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 1:5809 E 100 N
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-8226
Mailing Address - Country:US
Mailing Address - Phone:812-371-9898
Mailing Address - Fax:
Practice Address - Street 1:10509 HEARTLAND BLVD
Practice Address - Street 2:
Practice Address - City:CAMBY
Practice Address - State:IN
Practice Address - Zip Code:46113-9123
Practice Address - Country:US
Practice Address - Phone:812-371-9898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029365A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist