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General NPI Number Information
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NPI Number | 1811355688
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Entity Type | Individual
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Provider Name | LISA WILCOX FOWLER RPH
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Gender | Female
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 3545 CHAIN BRIDGE RD STE 102
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City | FAIRFAX
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State | VA
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Zip | 22030-2708
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Country | US
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Telephone | 571-732-4633
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Fax | 571-732-4643
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Provider Business Mailing Address
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Address Line | 3545 CHAIN BRIDGE RD STE 102
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City | FAIRFAX
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State | VA
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Zip | 22030-2708
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Country | US
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Telephone | 571-732-4633
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Fax | 571-732-4643
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03331630
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 057706
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 08982
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 19233
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S021905
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License Number State | AZ
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Taxonomy #6
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1-117754
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License Number State | KS
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Taxonomy #7
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 022865
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License Number State | KY
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Taxonomy #8
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PST.021598
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License Number State | LA
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Taxonomy #9
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 24188
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License Number State | MD
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Taxonomy #10
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH236963
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License Number State | MA
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Taxonomy #11
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302414520
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License Number State | MI
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Taxonomy #12
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17573
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License Number State | NE
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Taxonomy #13
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 22963
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License Number State | NV
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Taxonomy #14
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | R-19700
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License Number State | OK
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Taxonomy #15
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202220418
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License Number State | VA
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