DR. LISA M GARDNER (NPI# 1063406833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063406833 |
| Entity Type | Individual |
| Full Name | DR. LISA M GARDNER |
| Credential | PHARMD |
| Practice Address |
830 E Main St Melbourne AR 72556-1370 |
| Mailing Address |
Po Box 1370 Melbourne AR 72556-1370 |
| Practice Telephone | 8703687171 |
| Practice Fax Number | 8703685295 |
| Mailing Telephone | 8703687171 |
| Mailing Fax Number | 8703685295 |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2019-03-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 08467 | AR | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | AR STATE BOARD OF PHARMACY | PD08467 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972049468 | Lisa Gardner | Specialist/Technologist | 5001 W Dobbins Rd, Laveen, AZ 85339-9733 | 2017-01-09 |
| 1255781837 | Lisa Gardner | Physical Therapy Assistant | 956 Cherry St, Utica, NY 13502-3818 | 2016-06-15 |
| 1245577535 | Lisa Marie Gardner | Speech-Language Pathologist | 547 S Clark St Apt 305, Chicago, IL 60605-1546 | 2013-01-07 |
| 1639467814 | Lisa A Gardner | Registered Nurse | 12150 Loft Ct, Bristow, VA 20136-1230 | 2011-07-21 |
| 1316114499 | Lisa Franck Gardner | Physical Therapist | 7483 Cottonwood Dr, Denver, NC 28037-7685 | 2008-05-08 |
| 1801884333 | Lisa Hall Gardner | Nurse Practitioner | 438 W Brevard St, Tallahassee, FL 32301-1004 | 2005-10-10 |
| 1144695925 | Lisa Gardner | Pharmacist | S14w22605 Coral Dr, Waukesha, WI 53186-1538 | 2015-12-05 |
| 1093131690 | Lisa Ann Gardner | Physician Assistant | 4901 Lac De Ville Blvd, Rochester, NY 14618-5647 | 2014-03-07 |
| 1205101037 | Lisa Leah Gardner | Counselor | 753 N 35th St, 202, Seattle, WA 98103-8870 | 2012-03-12 |
| 1376715615 | Lisa Marie Gardner | Audiologist | 1601 Nw 114th St, Suite 230, Clive, IA 50325-7007 | 2008-03-27 |
| Street Address |
830 E MAIN ST |
| City | MELBOURNE |
| State | AR |
| Zip Code | 72556-1370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588124770 | Caeverett, Inc | Pharmacy | 830 E Main St, Melbourne, AR 72556 | 2019-03-22 |
| 1811003338 | S L Gardner Inc | Pharmacy | 830 E Main St, Melbourne, AR 72556 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275143950 | Brad Wheelis Family Dentistry Pllc | Clinic/Center | 1218 East Main St, Melbourne, AR 72556 | 2020-08-06 |
| 1932742640 | Abby Everett | Pharmacist | 803 E Main Street, Melbourne, AR 72556 | 2019-10-25 |
| 1154849065 | Baxter Regional Health System | Nurse Practitioner | 1019 East Main Street, Melbourne, AR 72556 | 2017-08-31 |
| 1265955512 | Kids El Melbourne | Pediatrics | 889 East Main, Melbourne, AR 72556 | 2017-07-19 |
| 1245752070 | Morgan Brittany Shirley | Nurse Practitioner | 1019 E. Main St., Melbourne, AR 72556 | 2017-07-13 |
| 1467988725 | Anita Love | Case Manager/Care Coordinator | 637 Esat Main St, Melbourne, AR 72556 | 2017-05-05 |
| 1558729236 | Regan Tharp | Developmental Therapist | 889 E. Main, Melbourne, AR 72556 | 2016-02-09 |
| 1740693274 | Richard Thomas Keefer | Social Worker | 637 East Main St, Melbourne, AR 72556 | 2014-06-02 |
| 1164858437 | Mary Grice Duncan | Pharmacist | 600 N. Main Street, Suite C, Melbourne, AR 72556 | 2013-09-18 |
| 1265871248 | Kidspiration Pediatric Therapy Services Too, Inc. | Clinic/Center | 905 East Main St, Melbourne, AR 72556 | 2013-06-23 |
| Find all providers in zip 72556 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871105981 | Jennifer Elbert | Pharmacist | 2176 Sarno Rd Ste 120, Melbourne, FL 32935-3086 | 2020-08-19 |
| 1013530419 | Ryan Thomas Kammerdener | Pharmacist | 3003 Bay Wind Ct, Melbourne, FL 32934 | 2020-05-20 |
| 1295360592 | Hiteshi Patel | Pharmacist | 3134 Hummingbird Way, Melbourne, FL 32940 | 2020-03-06 |
| 1932742640 | Abby Everett | Pharmacist | 803 E Main Street, Melbourne, AR 72556 | 2019-10-25 |
| 1659868982 | James Mezheritskiy | Pharmacist | 1278 Tipperary Dr, Melbourne, FL 32940-6028 | 2018-04-23 |
| 1578068128 | Michael Alan Donato | Pharmacist | 4315 Canby Dr, Melbourne, FL 32901-8888 | 2018-03-27 |
| 1083123632 | Christina Gendy | Pharmacist | 1515 Palm Bay Rd Ste 108, Melbourne, FL 32905-3863 | 2017-09-27 |
| 1073058954 | Jennifer Mooney | Pharmacist | 1515 Elizabeth St Ste J, Melbourne, FL 32901-3000 | 2016-12-30 |
| 1174979389 | Carlette Norwood-williams | Pharmacist | 2475 Jen Dr Ste 3, Melbourne, FL 32940-7480 | 2016-05-05 |
| 1447644588 | Bianca Knight | Pharmacist | 8252 Old Tramway Dr, Melbourne, FL 32940-2184 | 2015-03-26 |
| Find all providers in MELBOURNE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.