Individual
LISA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1850 E FAIRVIEW AVE, MERIDIAN, ID 83642-5702
(208) 887-5273
Mailing address
1850 E FAIRVIEW AVE, MERIDIAN, ID 83642-5702
(208) 887-5273
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
05/18/2026
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