Lisa Ann Tiede-Newland, RPH
Individual provider Active NPI Pharmacist · Huntsburg, OH
NPI 1295432003 · NPPES record last updated Feb 13, 2023
Key facts
- NPI
- 1295432003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03316772 (OH)
- Practice address
- 12466 Forest Rd
Huntsburg, OH 44046-9737 - Phone
- (585) 409-5883
- NPI assigned
- Feb 13, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03316772 | OH | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03316772 | OH | Yes |
Addresses
Primary practice location
12466 Forest Rd
Huntsburg, OH 44046-9737
Mailing address
12466 Forest Rd
Huntsburg, OH 44046-9737
Phone (585) 409-5883
Other providers in Huntsburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.