Provider Demographics
NPI:1679549893
Name:HERRE, CARON ANN (RPH, CGP)
Entity Type:Individual
Prefix:
First Name:CARON
Middle Name:ANN
Last Name:HERRE
Suffix:
Gender:F
Credentials:RPH, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3578-E HARTSEL DR
Mailing Address - Street 2:#342
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-2103
Mailing Address - Country:US
Mailing Address - Phone:719-964-4242
Mailing Address - Fax:719-637-7998
Practice Address - Street 1:6671 BITTERROOT DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-7324
Practice Address - Country:US
Practice Address - Phone:719-964-4242
Practice Address - Fax:719-637-7998
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14940183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist