Provider Demographics
NPI:1134551971
Name:LEMISTER, TARA LYNN (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:LYNN
Last Name:LEMISTER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:TARA
Other - Middle Name:LYNN
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1415 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-3825
Mailing Address - Country:US
Mailing Address - Phone:910-592-1208
Mailing Address - Fax:
Practice Address - Street 1:1415 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-3825
Practice Address - Country:US
Practice Address - Phone:910-592-1208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-03
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23494183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist