Provider Demographics
NPI:1902971229
Name:STEUBER, LORIE ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LORIE
Middle Name:ANN
Last Name:STEUBER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 S TULSA AVE
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72801-5646
Mailing Address - Country:US
Mailing Address - Phone:479-264-0070
Mailing Address - Fax:
Practice Address - Street 1:408 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:ATKINS
Practice Address - State:AR
Practice Address - Zip Code:72823-4149
Practice Address - Country:US
Practice Address - Phone:479-641-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD102971835G0303X, 1835N1003X, 1835P1200X, 183500000X
TXTX40143183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARPD10297OtherPHARMACIST LICENSE
TXTX40143OtherPHARMACIST LICENSE