Provider Demographics
NPI:1831472158
Name:CAVANAUGH, JAMIE JURKIEWICZ (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:JURKIEWICZ
Last Name:CAVANAUGH
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 1:101 MANNING DRIVE
Mailing Address - Street 2:CB # 7600
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:919-966-5149
Mailing Address - Fax:
Practice Address - Street 1:102 MASON FARM ROAD
Practice Address - Street 2:GENERAL INTERNAL MEDICINE CLINIC
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7745
Practice Address - Country:US
Practice Address - Phone:919-966-5596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC211451835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist