Provider Demographics
NPI:1508498361
Name:COONS, CARRIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:COONS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2945 SCOTTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-6331
Mailing Address - Country:US
Mailing Address - Phone:270-780-9328
Mailing Address - Fax:270-780-0386
Practice Address - Street 1:2945 SCOTTSVILLE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-6331
Practice Address - Country:US
Practice Address - Phone:270-780-9328
Practice Address - Fax:270-780-0386
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0159561835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist