Provider Demographics
NPI:1164623575
Name:ANDERSON, KARLA JEAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KARLA
Middle Name:JEAN
Last Name:ANDERSON
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 1:19550 N GRAYHAWK DR UNIT 1062
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3992
Mailing Address - Country:US
Mailing Address - Phone:602-525-8954
Mailing Address - Fax:480-538-0940
Practice Address - Street 1:19550 N GRAYHAWK DR UNIT 1062
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3992
Practice Address - Country:US
Practice Address - Phone:602-525-8954
Practice Address - Fax:480-538-0940
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist