Provider Demographics
NPI:1952719007
Name:BRUSS, CARRIE ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:ANN
Last Name:BRUSS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:BURGESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:304 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4938
Mailing Address - Country:US
Mailing Address - Phone:330-823-6921
Mailing Address - Fax:
Practice Address - Street 1:304 E STATE ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4938
Practice Address - Country:US
Practice Address - Phone:330-823-6921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2014-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233844183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist