Provider Demographics
NPI:1164738563
Name:CORRELL, JANET (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:CORRELL
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2082
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92018-2082
Mailing Address - Country:US
Mailing Address - Phone:760-729-4877
Mailing Address - Fax:
Practice Address - Street 1:955 TAMARACK AVE
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-3414
Practice Address - Country:US
Practice Address - Phone:760-729-4877
Practice Address - Fax:760-729-7696
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37160183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist