Provider Demographics
NPI:1427727114
Name:MINOR, KARLA JACOBS (RPH)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:JACOBS
Last Name:MINOR
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 1:226 NIX RD
Mailing Address - Street 2:
Mailing Address - City:HAZEL GREEN
Mailing Address - State:AL
Mailing Address - Zip Code:35750-6800
Mailing Address - Country:US
Mailing Address - Phone:205-508-5723
Mailing Address - Fax:
Practice Address - Street 1:274 SUTTON RD SE
Practice Address - Street 2:
Practice Address - City:OWENS CROSS ROADS
Practice Address - State:AL
Practice Address - Zip Code:35763-8753
Practice Address - Country:US
Practice Address - Phone:256-533-8982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12257183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist