Provider Demographics
NPI:1497032742
Name:CARTER, KERRY L (RPH)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:L
Last Name:CARTER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8799 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4713
Mailing Address - Country:US
Mailing Address - Phone:720-214-2620
Mailing Address - Fax:720-214-2305
Practice Address - Street 1:8799 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4713
Practice Address - Country:US
Practice Address - Phone:720-214-2620
Practice Address - Fax:720-214-2305
Is Sole Proprietor?:No
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist