Provider Demographics
NPI:1881134187
Name:STERLING, LISA PELTON (RPH)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:PELTON
Last Name:STERLING
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:NMN
Other - Last Name:PELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:911 MARYNELL LN
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-9116
Mailing Address - Country:US
Mailing Address - Phone:417-725-8151
Mailing Address - Fax:
Practice Address - Street 1:911 MARYNELL LN
Practice Address - Street 2:
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714-9116
Practice Address - Country:US
Practice Address - Phone:417-725-8151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003000301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist