Individual
MS. LISSA WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3606 MACLAY BLVD STE 102, TALLAHASSEE, FL 32312
(805) 877-1162
(850) 671-5009
Mailing address
3606 MACLAY BLVD STE 102, TALLAHASSEE, FL 32312
(805) 877-1162
(850) 671-5009
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
07609
TN
163WP0200X
Pediatric Registered Nurse
115113 R.N.
TN
364SP0200X
Pediatric Clinical Nurse Specialist
7609 A.P.N.
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5440116
—
TN
Enumeration date
02/17/2009
Last updated
09/21/2018
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