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Individual
LISA DUBOSE
Active
Individual
LISA DUBOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
R032817
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
224468795
—
AR
Enumeration date
05/19/2016
Last updated
04/30/2020
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