Healthcare Provider Details

I. General information

NPI: 1609316033
Provider Name (Legal Business Name): LISA JOY OHNSTAD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2017
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 WASHINGTON BLVD
NEWCASTLE WY
82701-2972
US

IV. Provider business mailing address

PO BOX 926
NEWCASTLE WY
82701-0926
US

V. Phone/Fax

Practice location:
  • Phone: 307-746-3721
  • Fax:
Mailing address:
  • Phone: 307-746-3721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3991
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number112269
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: