Provider Demographics
NPI:1871809723
Name:HARMON, LISA GALE (DPH)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:GALE
Last Name:HARMON
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 S MENDENHALL RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4244
Mailing Address - Country:US
Mailing Address - Phone:901-683-8843
Mailing Address - Fax:901-680-5621
Practice Address - Street 1:540 S MENDENHALL RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-4244
Practice Address - Country:US
Practice Address - Phone:901-683-8843
Practice Address - Fax:901-680-5621
Is Sole Proprietor?:No
Enumeration Date:2010-08-28
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN78491835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist