Provider Demographics
NPI:1568078889
Name:DEFEE, KARLA RAE (RPH)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:RAE
Last Name:DEFEE
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 1:15745 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:BAY MINETTE
Mailing Address - State:AL
Mailing Address - Zip Code:36507-8426
Mailing Address - Country:US
Mailing Address - Phone:251-387-5871
Mailing Address - Fax:
Practice Address - Street 1:3371 S ALABAMA AVE
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460-5645
Practice Address - Country:US
Practice Address - Phone:251-575-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21599183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist