Provider Demographics
NPI:1760771042
Name:ASHERBRANNER, KAREN LYNN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:ASHERBRANNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 HIGHWAY 29
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4620
Mailing Address - Country:US
Mailing Address - Phone:770-934-3585
Mailing Address - Fax:770-939-9130
Practice Address - Street 1:4005 HIGHWAY 29
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4620
Practice Address - Country:US
Practice Address - Phone:770-934-3585
Practice Address - Fax:770-939-9130
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH014325183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist