Provider Demographics
NPI:1538414545
Name:JAMIESON, ELIZABETH KATHLEEN (PHARMD, BCACP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KATHLEEN
Last Name:JAMIESON
Suffix:
Gender:F
Credentials:PHARMD, BCACP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:KATHLEEN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2544 N 52ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-4308
Mailing Address - Country:US
Mailing Address - Phone:402-305-3294
Mailing Address - Fax:
Practice Address - Street 1:4101 WOOLWORTH AVE
Practice Address - Street 2:PHARMACY 119
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-1850
Practice Address - Country:US
Practice Address - Phone:402-995-3677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE139141835P0018X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist