Provider Demographics
NPI:1386851830
Name:CALLAGHAN, CHRISTINA LYNN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:LYNN
Last Name:CALLAGHAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13176 BLACKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820-9671
Mailing Address - Country:US
Mailing Address - Phone:517-669-1013
Mailing Address - Fax:
Practice Address - Street 1:1550 W LAKE LANSING RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1386
Practice Address - Country:US
Practice Address - Phone:517-351-9445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027746183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist