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General NPI Number Information
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NPI Number | 1326320755
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Entity Type | Individual
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Provider Name | LISA M JACKMAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/12/2011
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Last Update Date | 09/12/2011
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Provider Practice Location Address
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Address Line | 283 MAIN ST
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City | NASHUA
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State | NH
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Zip | 03060-2937
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Country | US
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Telephone | 603-889-6124
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Fax | 603-889-6164
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Provider Business Mailing Address
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Address Line | 20 CELESTIAL WAY
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City | PEPPERELL
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State | MA
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Zip | 01463-1293
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Country | US
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Telephone | 508-364-5953
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | R2110
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH27465
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License Number State | MA
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