Provider Demographics
NPI:1427306570
Name:KEARNS, LISA ANNE (RPH)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANNE
Last Name:KEARNS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 ERVIN DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-6513
Mailing Address - Country:US
Mailing Address - Phone:336-250-1005
Mailing Address - Fax:
Practice Address - Street 1:880 ERVIN DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292
Practice Address - Country:US
Practice Address - Phone:336-250-1005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11381183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist