Active NPI
Lisa McNulty, RPH
- Pharmacist
- Elk River, MN
National Provider Identifier
1427657865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 116327
- Practice address
- 18185 Zane St NW
Elk River, MN 55330-4505 - Phone
- (612) 209-4944
- NPI assigned
- Oct 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 116327 | MN | Primary |
Addresses
Primary practice location
18185 Zane St NW
Elk River, MN 55330-4505
Mailing address
18185 Zane St NW
Elk River, MN 55330-4505
Phone (612) 209-4944
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116327 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602892800000",
"number": "1427657865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18185 ZANE ST NW",
"city": "ELK RIVER",
"state": "MN",
"postal_code": "553304505",
"telephone_number": "612-209-4944"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18185 ZANE ST NW",
"city": "ELK RIVER",
"state": "MN",
"postal_code": "553304505",
"telephone_number": "612-209-4944"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNULTY",
"first_name": "LISA",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-17",
"last_updated": "2020-10-17",
"certification_date": "2020-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "116327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk River, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.