Provider Demographics
NPI:1417241696
Name:FISKE, CHRISTINA (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:FISKE
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 1:1450 GREENLAND RD
Mailing Address - Street 2:
Mailing Address - City:GREENLAND
Mailing Address - State:NH
Mailing Address - Zip Code:03840-2438
Mailing Address - Country:US
Mailing Address - Phone:603-501-1471
Mailing Address - Fax:603-501-1481
Practice Address - Street 1:1450 GREENLAND RD
Practice Address - Street 2:T2530
Practice Address - City:GREENLAND
Practice Address - State:NH
Practice Address - Zip Code:03840-2438
Practice Address - Country:US
Practice Address - Phone:603-501-1471
Practice Address - Fax:603-501-1481
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-05
Last Update Date:2011-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3272183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist