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Individual
LISA E KOONCE
Active
Individual
LISA E KOONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
K155446
IA
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
K155446
IA
363LP0200X
Pediatric Nurse Practitioner
K155446
IA
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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