Provider Demographics
NPI:1952993529
Name:BRANDT, KAREN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BRANDT
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 1:495 WEMBLEY CIR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-6755
Mailing Address - Country:US
Mailing Address - Phone:404-520-2654
Mailing Address - Fax:
Practice Address - Street 1:495 WEMBLEY CIR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-6755
Practice Address - Country:US
Practice Address - Phone:404-520-2654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40996183500000X
GARPH017675183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist