Provider Demographics
NPI:1427546324
Name:CARLSON, AIMEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:
Last Name:CARLSON
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 1:1836 E APACHE BLVD LOT 46
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-6019
Mailing Address - Country:US
Mailing Address - Phone:386-212-4079
Mailing Address - Fax:
Practice Address - Street 1:3809 E WATKINS ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-7264
Practice Address - Country:US
Practice Address - Phone:386-212-4079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist