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NPI Code Detail

MEDICARE: MS. LISA ANN DEVONICK PHARMD

MEDICARE: MS. LISA ANN DEVONICK PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist18336NV

General Provider Information

NPI Number : 1417205048
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LISA ANN DEVONICK PHARMD
Provider Business Mailing Address
First Line : 6242 BLACK CINDER CT
Second Line :
City : SPARKS
State : NV
Zip : 89436-7020
Country : US
Telephone Number : 407-284-0568
Fax Number :
Provider Business Practice Location Address
First Line : 3000 VISTA BLVD
Second Line :
City : SPARKS
State : NV
Zip : 89436-6702
Country : US
Telephone Number : 775-359-7044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2012
Last Update Date : 08/29/2012

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Directions to “ MS. LISA ANN DEVONICK PHARMD” Practice Location

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