Provider Demographics
NPI:1326061276
Name:FRALEY, KAREN S (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:S
Last Name:FRALEY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 VICTORIA LN
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-6808
Mailing Address - Country:US
Mailing Address - Phone:618-256-4741
Mailing Address - Fax:618-256-4303
Practice Address - Street 1:310 W LOSEY ST
Practice Address - Street 2:375 MDSS/SGSP
Practice Address - City:SCOTT AFB
Practice Address - State:IL
Practice Address - Zip Code:62225-5250
Practice Address - Country:US
Practice Address - Phone:618-256-4741
Practice Address - Fax:618-256-4303
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10566183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist