Provider Demographics
NPI:1942419213
Name:ISHEE, SARAH LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNN
Last Name:ISHEE
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 1:1504 HIGHWAY 29 N
Mailing Address - Street 2:
Mailing Address - City:ELLISVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39437-5125
Mailing Address - Country:US
Mailing Address - Phone:601-310-9038
Mailing Address - Fax:
Practice Address - Street 1:100 HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:PETAL
Practice Address - State:MS
Practice Address - Zip Code:39465-2881
Practice Address - Country:US
Practice Address - Phone:601-545-2056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-09922183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist