Provider Demographics
NPI:1700209350
Name:HATFIELD-BARAN, LISA RENEE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:RENEE
Last Name:HATFIELD-BARAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:RENEE
Other - Last Name:HATFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARM D
Mailing Address - Street 1:4005 SW BANBURY DR
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-7860
Mailing Address - Country:US
Mailing Address - Phone:479-903-5815
Mailing Address - Fax:
Practice Address - Street 1:4005 SW BANBURY DR
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-7860
Practice Address - Country:US
Practice Address - Phone:479-903-5815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD11660183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist