Provider Demographics
NPI:1710587167
Name:MILLER, CARRIE QUINN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:QUINN
Last Name:MILLER
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 1:120 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8264
Mailing Address - Country:US
Mailing Address - Phone:859-229-9626
Mailing Address - Fax:
Practice Address - Street 1:200 WALMART WAY
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-7217
Practice Address - Country:US
Practice Address - Phone:606-784-3266
Practice Address - Fax:606-783-9766
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY014045OtherSTATE LICENSE NUMBER