Individual
LISA A HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D.
Contact information
Practice address
10751 W OVERLAND RD, BOISE, ID 83709-1375
(208) 373-5233
(208) 373-5227
Mailing address
10751 W OVERLAND RD, BOISE, ID 83709-1375
(208) 373-5233
(208) 373-5227
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5364
ID
Other
Enumeration date
06/19/2013
Last updated
06/19/2013
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