Provider Demographics
NPI:1982937397
Name:ISBELL, CARISSA L (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CARISSA
Middle Name:L
Last Name:ISBELL
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 1:1664 E STONE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4663
Mailing Address - Country:US
Mailing Address - Phone:423-392-0593
Mailing Address - Fax:
Practice Address - Street 1:1664 E STONE DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4663
Practice Address - Country:US
Practice Address - Phone:423-392-0593
Practice Address - Fax:423-392-4094
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33060183500000X
VA2209040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist