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Individual

LISA IANNEILLO RUBINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1717 OAK PARK BLVD FL 3, LAKE CHARLES, LA 70601-8990
(337) 494-4720
(337) 494-2085
Mailing address
PO BOX 122425 DEPT 2425, DALLAS, TX 75312-2425
(337) 494-2921
(337) 494-6523

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP04844
LA

Other

Enumeration date
10/25/2017
Last updated
06/09/2022
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