Provider Demographics
NPI:1912598277
Name:MALOY, KARRIE ANNE
Entity Type:Individual
Prefix:
First Name:KARRIE
Middle Name:ANNE
Last Name:MALOY
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 1:456 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-3055
Mailing Address - Country:US
Mailing Address - Phone:330-503-4928
Mailing Address - Fax:
Practice Address - Street 1:456 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:OH
Practice Address - Zip Code:44420-3055
Practice Address - Country:US
Practice Address - Phone:330-503-4928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide