Individual
LISA K HYDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
2917 E MOON DIPPER CT, MERIDIAN, ID 83642-9138
(208) 867-5561
Mailing address
2917 E MOON DIPPER CT, MERIDIAN, ID 83642-9138
(208) 867-5561
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
N-22291
ID
Other
Enumeration date
02/25/2010
Last updated
02/25/2010
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