Provider Demographics
NPI:1205262797
Name:LISMAN, CHRISTINE (RPH)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:LISMAN
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 1:11 TILLER RD
Mailing Address - Street 2:
Mailing Address - City:SHAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18708-9677
Mailing Address - Country:US
Mailing Address - Phone:570-696-1588
Mailing Address - Fax:
Practice Address - Street 1:11 TILLER RD
Practice Address - Street 2:
Practice Address - City:SHAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18708-9677
Practice Address - Country:US
Practice Address - Phone:570-696-1588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040797L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist