Individual
MS. LISA DIANE PIERCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS PHARM
Contact information
Practice address
1613 GLENN BLVD SW, FT PAYNE, AL 35968-4565
(256) 845-0128
Mailing address
1613 GLENN BLVD SW, FT PAYNE, AL 35968
(256) 677-1416
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
16643
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16643
ALABAMA BOARD OF PHARMACY
AL
01
—
9047
NCBOP LICENSE #
NC
Enumeration date
09/28/2007
Last updated
06/28/2012
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