Provider Demographics
NPI:1801617824
Name:URENA, CARRIE (PHARMD, BCPS)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:URENA
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:DUPLISEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 690
Mailing Address - Street 2:
Mailing Address - City:KLAWOCK
Mailing Address - State:AK
Mailing Address - Zip Code:99925-0690
Mailing Address - Country:US
Mailing Address - Phone:907-888-8234
Mailing Address - Fax:
Practice Address - Street 1:7300 KLAWOCK HOLLIS HWY
Practice Address - Street 2:
Practice Address - City:KLAWOCK
Practice Address - State:AK
Practice Address - Zip Code:99925
Practice Address - Country:US
Practice Address - Phone:907-523-4313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1963761835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy