Provider Demographics
NPI:1275926958
Name:POPPLETON, LORI ANN (RPH)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:POPPLETON
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 1:3264 CANYON PL
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-8180
Mailing Address - Country:US
Mailing Address - Phone:208-420-0044
Mailing Address - Fax:
Practice Address - Street 1:3264 CANYON PL
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-8180
Practice Address - Country:US
Practice Address - Phone:208-420-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP5707183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist