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General NPI Number Information
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NPI Number | 1891572905
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Entity Type | Individual
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Provider Name | LISA PATTERSON HUBBARD PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 2276 E RIVERSIDE DR
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City | SAINT GEORGE
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State | UT
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Zip | 84790-2636
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Country | US
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Telephone | 435-986-2565
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Fax |
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Provider Business Mailing Address
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Address Line | 3374 S PECOS DR
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City | WASHINGTON
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State | UT
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Zip | 84780-3445
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Country | US
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Telephone | 208-871-3988
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Fax |
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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 | P6091
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License Number State | ID
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