Provider Demographics
NPI:1366468522
Name:SAPPE, CARLA STANLEY (PHARMD, CDM)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:STANLEY
Last Name:SAPPE
Suffix:
Gender:F
Credentials:PHARMD, CDM
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:LEIGH
Other - Last Name:STANLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 CHAPPELL ST
Mailing Address - Street 2:
Mailing Address - City:GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:31031-4120
Mailing Address - Country:US
Mailing Address - Phone:478-628-1522
Mailing Address - Fax:
Practice Address - Street 1:240 MILLEDGEVILLE HWY
Practice Address - Street 2:
Practice Address - City:GORDON
Practice Address - State:GA
Practice Address - Zip Code:31031-3827
Practice Address - Country:US
Practice Address - Phone:478-628-2425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA21241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist