Provider Demographics
NPI:1780984310
Name:EASLEY, KAREN ANN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ANN
Last Name:EASLEY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4961 BROOKBURN DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2779
Mailing Address - Country:US
Mailing Address - Phone:858-259-0307
Mailing Address - Fax:
Practice Address - Street 1:3850 VALLEY CENTRE DRIVE
Practice Address - Street 2:VONS 2119 PHARMACY
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130
Practice Address - Country:US
Practice Address - Phone:858-793-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41103183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist