Individual
LISA MCNULTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
18185 ZANE ST NW, ELK RIVER, MN 55330-4505
(612) 209-4944
Mailing address
18185 ZANE ST NW, ELK RIVER, MN 55330-4505
(612) 209-4944
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
116327
MN
Other
Enumeration date
10/17/2020
Last updated
10/17/2020
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