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General NPI Number Information
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NPI Number | 1790077675
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Entity Type | Individual
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Provider Name | LAURA S LISKEY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/10/2011
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 2800 ARCTIC AVE
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-3040
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Country | US
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Telephone | 757-422-2154
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Fax | 757-422-3221
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Provider Business Mailing Address
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Address Line | 2800 ARCTIC AVE
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-3040
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Country | US
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Telephone | 757-422-2154
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Fax | 757-422-3221
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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 | 0202012805
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1835N0905X
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Taxonomy Name | Nuclear Pharmacist
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License Number | 0202012805
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License Number State | VA
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