Individual
LISA JO FARRIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-6600
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-037225
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010163
BLUE CROSS
AL
05
—
000010163
—
AL
01
—
500016501
RAILROAD MEDICARE
AL
01
—
S78481
VIVA
AL
Enumeration date
06/15/2006
Last updated
06/29/2023
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