Provider Demographics
NPI:1730966227
Name:KNISLEY, JAMIE JOANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:JOANN
Last Name:KNISLEY
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 1:14101 N EASTERN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5860
Mailing Address - Country:US
Mailing Address - Phone:405-562-1800
Mailing Address - Fax:405-562-1880
Practice Address - Street 1:14101 N EASTERN AVE STE A
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5860
Practice Address - Country:US
Practice Address - Phone:405-562-1800
Practice Address - Fax:405-562-1880
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK202461835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist