SHANNAN MARIE CARROLL (NPI# 1952786428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952786428 |
| Entity Type | Individual |
| Full Name | SHANNAN MARIE CARROLL |
| Credential | PHARMD |
| Practice Address |
700 E 21st St Clovis NM 88101-3703 |
| Mailing Address |
612 Providence Cir Clovis NM 88101-1082 |
| Practice Telephone | 5757623851 |
| Mailing Telephone | 4792006453 |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2015-07-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 56746 | TX | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | RP00008400 | NM | Pharmacy Service Providers |
| Street Address |
700 E 21ST ST |
| City | CLOVIS |
| State | NM |
| Zip Code | 88101-3703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457366353 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 700 E 21st St, Clovis, NM 88101-3703 | 2006-07-29 |
| 1912514803 | Keng Man Wai | Pharmacist | 700 E 21st St, Clovis, NM 88101-3703 | 2020-09-25 |
| 1033638796 | Xondria Jennifer Self | Pharmacist | 700 E 21st St, Clovis, NM 88101-3703 | 2017-09-13 |
| 1316460108 | Jonathan Wesley Delong | Pharmacist | 700 E 21st St, Clovis, NM 88101-3703 | 2017-07-24 |
| 1457704934 | Shem Gichuhi | Pharmacist | 700 E 21st St, Clovis, NM 88101-3703 | 2016-07-19 |
| 1447651450 | Christopher Livesay | Pharmacist | 700 E 21st St, Clovis, NM 88101-3703 | 2014-09-09 |
| 1952658882 | Semana Marie Seukteoma | Pharmacist | 700 E 21st St, Clovis, NM 88101-3703 | 2012-08-09 |
| 1144577065 | James Herman | Pharmacist | 700 E 21st St, Clovis, NM 88101-3703 | 2012-08-09 |
| 1518244599 | April Michelle Stafford | Pharmacist | 700 E 21st St, Clovis, NM 88101-3703 | 2011-11-04 |
| 1962782003 | Ashley Erin Roder | Pharmacist | 700 E 21st St, Clovis, NM 88101-3703 | 2011-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134748692 | Patrick James Scollon | Military Health Care Provider | 104 W D. L. Ingram Ave, Cannon Afb, Nm 88101, Cannon Afb, NM 88101 | 2020-04-14 |
| 1285274878 | Keishla Cota | Physical Therapist | 100 East Manana Blvd, Unit 1, Clovis, NM 88101 | 2020-01-10 |
| 1659927283 | Ndeye Ndour | Nurse Anesthetist, Certified Registered | 2100 N M.l.k. Jr Blvd, Clovis, NM 88101 | 2019-08-09 |
| 1679132468 | Justine Nicole Nunez | Nurse Practitioner | 2301 North Doctor Martin Luther King Boulevard, Clovis, NM 88101 | 2019-06-06 |
| 1518453521 | Moore Psychological Services, Pllc | Social Worker | 1908 West 21st Street, Clovis, NM 88101 | 2018-07-03 |
| 1912494006 | Raesha Russell | Behavior Technician | 214 West 9th St, Clovis, NM 88101 | 2018-04-16 |
| 1013425800 | Vanessa Yardley | Registered Nurse | 2100 N. Martin Luther King Jr. Blvd., Clovis, NM 88101 | 2018-01-16 |
| 1699204230 | Olivia Garcia | Technician, Other | 1100 W 21st Street, Clovis, NM 88101 | 2017-06-07 |
| 1578006250 | Mary Ellen Gray | Technician, Other | 9408 B Vermont Court, Clovis, NM 88101 | 2016-11-29 |
| 1205296977 | Malaney Harmon | Behavioral Analyst | 2700 E 7th St., Clovis, NM 88101 | 2016-02-24 |
| Find all providers in zip 88101 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730791260 | Gabriela Dutra-clarke | Pharmacist | 1712 Burgan Ave, Clovis, CA 93611-3158 | 2020-08-17 |
| 1285254045 | Inga Sarkisian | Pharmacist | 3445 Amanecer Ave, Clovis, CA 93619-5189 | 2020-04-22 |
| 1952932923 | Tia Tang | Pharmacist | 12246 N Via Piemonte Ave, Clovis, CA 93619-8389 | 2020-01-29 |
| 1235798695 | Lien Nguyen | Pharmacist | 3522 Smith Ln, Clovis, CA 93619-4311 | 2019-06-10 |
| 1033773122 | Mao Thao | Pharmacist | 2133 Shaw Avenue, Clovis, CA 93611 | 2019-04-24 |
| 1518449289 | Colton Ray Dant | Pharmacist | 2401 W 21st St, Clovis, NM 88101-2006 | 2018-08-30 |
| 1407369275 | Tony Minh Ta | Pharmacist | 159 W Shaw Ave, Clovis, CA 93612-3726 | 2017-11-14 |
| 1023521291 | Mei Feng Guan | Pharmacist | 745 N Fowler Ave Apt 230, Clovis, CA 93611-6876 | 2017-11-10 |
| 1659809507 | Allen Keshishian Namagerdi | Pharmacist | 111 W 9th St Apt 272, Clovis, CA 93612-1734 | 2017-05-23 |
| 1417482464 | Tiffanie Guy | Pharmacist | 2810 Willow Ave Apt 206, Clovis, CA 93612 | 2017-04-27 |
| Find all providers in CLOVIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.