Provider Demographics
NPI:1629450176
Name:CARLISLE, JAMIE FAIRBANKS (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:FAIRBANKS
Last Name:CARLISLE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 KELLY RD
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-9572
Mailing Address - Country:US
Mailing Address - Phone:919-303-6204
Mailing Address - Fax:919-249-5324
Practice Address - Street 1:1441 KELLY RD
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-9572
Practice Address - Country:US
Practice Address - Phone:919-303-6204
Practice Address - Fax:919-249-5324
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27267183500000X
AL18670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist