Provider Demographics
NPI:1437430725
Name:CARNEY, MISTY (PHARM D)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:
Last Name:CARNEY
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 1:25 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-1842
Mailing Address - Country:US
Mailing Address - Phone:301-932-9826
Mailing Address - Fax:301-932-4294
Practice Address - Street 1:25 HIGH ST
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-1842
Practice Address - Country:US
Practice Address - Phone:301-932-9826
Practice Address - Fax:301-932-4294
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19292183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist