Healthcare Provider Details

I. General information

NPI: 1134088834
Provider Name (Legal Business Name): ELISE JOHN PHARMD, CPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 STATE FARM RD
BOONE NC
28607-4948
US

IV. Provider business mailing address

PO BOX 1490
BOONE NC
28607-0682
US

V. Phone/Fax

Practice location:
  • Phone: 828-262-3886
  • Fax:
Mailing address:
  • Phone: 828-262-3886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number30539
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: