Provider Demographics
NPI:1710149596
Name:EISEMANN, KRISTA L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:L
Last Name:EISEMANN
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 1:10220 SHINGLE LANDING RD
Mailing Address - Street 2:
Mailing Address - City:BISHOPVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21813-1438
Mailing Address - Country:US
Mailing Address - Phone:410-352-5441
Mailing Address - Fax:
Practice Address - Street 1:1615 TREE SAP CT
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-9403
Practice Address - Country:US
Practice Address - Phone:410-677-0561
Practice Address - Fax:410-677-0562
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist