Provider Demographics
NPI:1174589162
Name:NEISINGER, CHRISTINA REBEKAH (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:REBEKAH
Last Name:NEISINGER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:CHRISTINA
Other - Middle Name:REBEKAH
Other - Last Name:RENGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 S 99TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-9700
Mailing Address - Country:US
Mailing Address - Phone:425-299-2028
Mailing Address - Fax:
Practice Address - Street 1:2858 N PINAL AVE
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-7917
Practice Address - Country:US
Practice Address - Phone:520-426-4701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00063929183500000X
AZS019797183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPH00063929OtherPHARMACIST
WAPH60113517OtherWASHINGTON STATE BOARD OF PHARMACY
AZS019797OtherARIZONA STATE BOARD OF PHARMACY