Provider Demographics
NPI:1679171490
Name:GEHRMAN, LISA CHRISTINA (PHARMD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:CHRISTINA
Last Name:GEHRMAN
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 1:2188 220TH ST
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:WI
Mailing Address - Zip Code:54007-7516
Mailing Address - Country:US
Mailing Address - Phone:715-410-5608
Mailing Address - Fax:
Practice Address - Street 1:2212 GLACIER DR
Practice Address - Street 2:
Practice Address - City:SAINT CROIX FALLS
Practice Address - State:WI
Practice Address - Zip Code:54024-8347
Practice Address - Country:US
Practice Address - Phone:715-483-1499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19555183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist