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Individual

MRS. LISA MARIE TYLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1 VA CTR, MDP 171HB, AUGUSTA, ME 04330-6719
(207) 623-8411
(207) 623-5771
Mailing address
PO BOX 3155, AUGUSTA, ME 04330-3155
(207) 242-6071

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
034488
ME

Other

Enumeration date
07/27/2006
Last updated
07/08/2007
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