Individual
DR. TIFFANY A CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
401 N MAIN ST, BREWER, ME 04412-1802
(207) 275-3300
(207) 275-3310
Mailing address
401 N MAIN ST, BREWER, ME 04412-1802
(207) 275-3300
(207) 275-3310
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR5208
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PR5208
PHARMACIST LICENSE
ME
Enumeration date
09/25/2016
Last updated
09/25/2016
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