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Individual

LORI LYNN NELSON ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
16515 S 40TH ST STE 123, PHOENIX, AZ 85048-0559
(480) 706-0620
(480) 706-0489
Mailing address
16515 S 40TH ST STE 123, PHOENIX, AZ 85048-0559
(480) 706-0620
(480) 706-0489

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S9955
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
S009955
ARIZONA BOARD OF PHARMACY LICENSE
AZ
Enumeration date
05/31/2019
Last updated
05/31/2019
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