Provider Demographics
NPI:1265279319
Name:POWER, KARLIE ANNE
Entity type:Individual
Prefix:
First Name:KARLIE
Middle Name:ANNE
Last Name:POWER
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 1:539 N WESTOVER BLVD APT 1122
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-1975
Mailing Address - Country:US
Mailing Address - Phone:508-944-6114
Mailing Address - Fax:
Practice Address - Street 1:2351 DAWSON RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-2435
Practice Address - Country:US
Practice Address - Phone:229-888-6166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-15
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA034536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist