Provider Demographics
NPI:1083412787
Name:HANNAH, LISA MARIE (RPH)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:HANNAH
Suffix:
Gender:
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9334 DAYTON PIKE
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-4855
Mailing Address - Country:US
Mailing Address - Phone:423-332-9957
Mailing Address - Fax:423-332-9611
Practice Address - Street 1:9334 DAYTON PIKE
Practice Address - Street 2:
Practice Address - City:SODDY DAISY
Practice Address - State:TN
Practice Address - Zip Code:37379-4855
Practice Address - Country:US
Practice Address - Phone:423-332-9957
Practice Address - Fax:423-332-9611
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9094183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist