Provider Demographics
NPI:1952140543
Name:KNEBEL, KARRIE (RPH)
Entity type:Individual
Prefix:
First Name:KARRIE
Middle Name:
Last Name:KNEBEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 GOODMAN RD APT 3307
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-1801
Mailing Address - Country:US
Mailing Address - Phone:574-727-0141
Mailing Address - Fax:
Practice Address - Street 1:3299 TCHULATECH DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-8001
Practice Address - Country:US
Practice Address - Phone:901-827-4085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY024011183500000X
IN26017677A183500000X
MST-101008183500000X
TN0000046935183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist