Provider Demographics
NPI:1457949950
Name:KISSINGER, LINDA LOU (CPHT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LOU
Last Name:KISSINGER
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-9532
Mailing Address - Country:US
Mailing Address - Phone:717-540-6011
Mailing Address - Fax:717-540-6021
Practice Address - Street 1:4300 LINGLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-9532
Practice Address - Country:US
Practice Address - Phone:717-540-6011
Practice Address - Fax:717-540-6021
Is Sole Proprietor?:No
Enumeration Date:2021-01-10
Last Update Date:2021-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
22011020355496183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician