Provider Demographics
NPI:1508035833
Name:PATTON, LISA GAIL (PHARMD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:GAIL
Last Name:PATTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 NORWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-1257
Mailing Address - Country:US
Mailing Address - Phone:859-626-1666
Mailing Address - Fax:
Practice Address - Street 1:60 MERCY CT
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:KY
Practice Address - Zip Code:40336-1331
Practice Address - Country:US
Practice Address - Phone:606-726-2146
Practice Address - Fax:606-723-3301
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2016-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY011833183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist