Provider Demographics
NPI:1265850168
Name:COLWELL, KAREN KELLEY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:KELLEY
Last Name:COLWELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3886 HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577
Mailing Address - Country:US
Mailing Address - Phone:706-282-1193
Mailing Address - Fax:706-282-1813
Practice Address - Street 1:3886 HWY 17
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577
Practice Address - Country:US
Practice Address - Phone:706-282-1193
Practice Address - Fax:706-282-1813
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-29
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH019170183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist