Provider Demographics
NPI:1801037510
Name:CROKER, LISA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:CROKER
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 1:67 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-1604
Mailing Address - Country:US
Mailing Address - Phone:570-436-1626
Mailing Address - Fax:570-689-6749
Practice Address - Street 1:67 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-1604
Practice Address - Country:US
Practice Address - Phone:570-436-1626
Practice Address - Fax:570-689-6749
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2009-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442849183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist