Provider Demographics
NPI:1811537095
Name:CARROLL, MARLA ANN (RPH)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:ANN
Last Name:CARROLL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MARLA
Other - Middle Name:ANN
Other - Last Name:NORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 HIGHLANDER POINT DRIVE
Mailing Address - Street 2:
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119
Mailing Address - Country:US
Mailing Address - Phone:812-923-9013
Mailing Address - Fax:812-923-2575
Practice Address - Street 1:815 HIGHLANDER POINT DRIVE
Practice Address - Street 2:
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119
Practice Address - Country:US
Practice Address - Phone:812-923-9013
Practice Address - Fax:812-923-2575
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2601825A1835P0018X
IN26018925A1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist