Provider Demographics
NPI:1770720922
Name:BROWN, LISA KRISTINE (PHARMD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:KRISTINE
Last Name:BROWN
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 1:22099 CUDDIHY RD
Mailing Address - Street 2:
Mailing Address - City:PATUXENT RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:20670-1194
Mailing Address - Country:US
Mailing Address - Phone:301-342-9744
Mailing Address - Fax:
Practice Address - Street 1:22099 CUDDIHY RD
Practice Address - Street 2:BLDG 2369
Practice Address - City:PATUXENT RIVER
Practice Address - State:MD
Practice Address - Zip Code:20670-1194
Practice Address - Country:US
Practice Address - Phone:301-342-9744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18639183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist