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Individual
LISA M FOX
Active
Individual
LISA M FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71004423A
IN
363LA2100X
Acute Care Nurse Practitioner
28104395A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000822694
ANTHEM
IN
05
—
201178520
—
IN
01
—
P01261819
MEDICARE RR PTAN
IN
Enumeration date
04/26/2013
Last updated
11/27/2023
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