Provider Demographics
NPI:1487885919
Name:STAGGS, CARLA ODLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:ODLE
Last Name:STAGGS
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 1:313 HIGHWAY 13 S
Mailing Address - Street 2:
Mailing Address - City:COLLINWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:38450-4609
Mailing Address - Country:US
Mailing Address - Phone:931-724-9197
Mailing Address - Fax:
Practice Address - Street 1:313 HIGHWAY 13 S
Practice Address - Street 2:
Practice Address - City:COLLINWOOD
Practice Address - State:TN
Practice Address - Zip Code:38450-4609
Practice Address - Country:US
Practice Address - Phone:931-724-9197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33698183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist