Healthcare Provider Details

I. General information

NPI: 1487135851
Provider Name (Legal Business Name): KATHERINE CARNES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 S EDWARD DR
TEMPE AZ
85281-6200
US

IV. Provider business mailing address

1626 S EDWARD DR
TEMPE AZ
85281-6200
US

V. Phone/Fax

Practice location:
  • Phone: 480-246-3975
  • Fax:
Mailing address:
  • Phone: 480-246-3975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS023501
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: