Individual
LISA G EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
1835N1003X
Nutrition Support Pharmacist
Primary
015851
KY
1835N1003X
Nutrition Support Pharmacist
029533
MO
1835N1003X
Nutrition Support Pharmacist
1-14133
KS
Other
Enumeration date
07/26/2012
Last updated
07/26/2012
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