Provider Demographics
NPI:1720204951
Name:KNORR, CAROL ANN (RPH)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:KNORR
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 1:12 BRIAR DR
Mailing Address - Street 2:
Mailing Address - City:VELVA
Mailing Address - State:ND
Mailing Address - Zip Code:58790-7419
Mailing Address - Country:US
Mailing Address - Phone:701-338-2540
Mailing Address - Fax:
Practice Address - Street 1:20 BURDICK EXPY W
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4498
Practice Address - Country:US
Practice Address - Phone:701-838-2213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3902183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist