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Individual
MISS LISA M PARKER
Active
Individual
MISS LISA M PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201502986NP-PP
OR
363LF0000X
Family Nurse Practitioner
R852821
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08657850
—
MS
01
—
12027545
CAQH
MS
Enumeration date
09/15/2009
Last updated
09/13/2019
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