MEDICARE: MRS. LISA ANN WILKINSON PHARMD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	26021712A	IN

General Provider Information

NPI Number	:	1184907727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA ANN WILKINSON PHARMD.

Provider Business Mailing Address
First Line	:	18515 DOW KNOB RD
Second Line	:
City	:	BORDEN
State	:	IN
Zip	:	47106-8201
Country	:	US
Telephone Number	:	502-415-4006
Fax Number	:

Provider Business Practice Location Address
First Line	:	1702 E SPRING ST
Second Line	:
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-1652
Country	:	US
Telephone Number	:	812-949-5015
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2011
Last Update Date	:	09/20/2011

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