Provider Demographics
NPI:1073879102
Name:PEAT, KAREN (PHARMD)
Entity Type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:
Last Name:PEAT
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 1:210 N CHURCH ST
Mailing Address - Street 2:#3303
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-2256
Mailing Address - Country:US
Mailing Address - Phone:623-640-9287
Mailing Address - Fax:
Practice Address - Street 1:231 N GRAHAM ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-1463
Practice Address - Country:US
Practice Address - Phone:704-373-2930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist