Provider Demographics
NPI:1881667707
Name:ANDERSON, LORI ANN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:FINNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:4833 N COUNTY ROAD 11C
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2319
Mailing Address - Country:US
Mailing Address - Phone:970-231-5973
Mailing Address - Fax:855-205-9926
Practice Address - Street 1:350 E 7TH ST STE 12
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-4878
Practice Address - Country:US
Practice Address - Phone:970-231-1175
Practice Address - Fax:855-205-9926
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12678OtherPHARMACIST LICENSE