Healthcare Provider Details

I. General information

NPI: 1265984538
Provider Name (Legal Business Name): ALISSA KARR PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST # WH330
LEXINGTON KY
40536-4224
US

IV. Provider business mailing address

800 ROSE ST # H110
LEXINGTON KY
40536-4224
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-4950
  • Fax:
Mailing address:
  • Phone: 859-218-4950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number017289
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: