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General NPI Number Information
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NPI Number | 1417178690
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Entity Type | Individual
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Provider Name | LISA MARIE TRISSELL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 404B WASHINGTON ST
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City | CAMBRIDGE
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State | MD
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Zip | 21613-2810
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Country | US
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Telephone | 410-221-6400
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Fax | 410-221-0600
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Provider Business Mailing Address
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Address Line | 5619 BELLE AIRE RD
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City | EAST NEW MARKET
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State | MD
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Zip | 21631-1635
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Country | US
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Telephone | 410-523-5202
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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 | 17678
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License Number State | MD
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