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General NPI Number Information
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NPI Number | 1336022144
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Entity Type | Individual
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Provider Name | LISA LYNN KERRIDGE PHARM.D, BCPS
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Gender |
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 5698 W US 2
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City | MANISTIQUE
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State | MI
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Zip | 49854
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Country | US
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Telephone | 906-341-9546
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Fax | 906-341-1321
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Provider Business Mailing Address
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Address Line | 211 S MAPLE ST LISALYNN24@HOTMAIL.COM
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City | MANISTIQUE
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State | MI
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Zip | 49854
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Country | US
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Telephone | 734-834-9996
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | PS57818
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License Number State | FL
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