Provider Demographics
NPI:1508545310
Name:SIMONS, LISA ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:SIMONS
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 1:751 FOREST AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2875
Mailing Address - Country:US
Mailing Address - Phone:740-455-7545
Mailing Address - Fax:740-455-7583
Practice Address - Street 1:751 FOREST AVE STE 302
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2875
Practice Address - Country:US
Practice Address - Phone:740-455-7545
Practice Address - Fax:740-455-7583
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03319812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist