Individual
LISA KATHERINE TABOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, ACNP-BC
Contact information
Practice address
6545 S FORT APACHE RD STE 135-228, LAS VEGAS, NV 89148-6752
(337) 804-2049
(877) 866-3181
Mailing address
9900 BREN ROAD EAST, MAIL ROUTE MN 008-8213, MINNETONKA, MN 55343
(337) 804-2049
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN002065
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477427
—
LA
Enumeration date
07/07/2005
Last updated
06/30/2020
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