Individual
MRS. LISA ANN NEWNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 460-1418
Mailing address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 460-1418
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26015751
IN
Other
Enumeration date
08/12/2006
Last updated
07/16/2007
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