Provider Demographics
NPI:1558496380
Name:BURNS, LIZA (RPH)
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:
Last Name:BURNS
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 1:7733 DONEGAL DRIVE SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802
Mailing Address - Country:US
Mailing Address - Phone:256-883-8007
Mailing Address - Fax:
Practice Address - Street 1:7733 DONEGAL DR SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2774
Practice Address - Country:US
Practice Address - Phone:256-883-8007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9061183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist