Individual
LISA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
10751 W OVERLAND RD, BOISE, ID 83709-1375
(208) 373-5233
Mailing address
10751 W OVERLAND RD, BOISE, ID 83709-1375
(208) 373-5233
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7268
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P7268
PHARMACIST LICENSE
ID
Enumeration date
06/25/2015
Last updated
06/25/2015
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