Individual
LISSA L GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
6350 US ROUTE 60 E, BARBOURSVILLE, WV 25504
(304) 399-3350
(304) 955-5047
Mailing address
2585 3RD AVE, HUNTINGTON, WV 25703-1642
(304) 697-1396
(304) 697-2086
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN67319
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810023589
—
WV
Enumeration date
12/10/2009
Last updated
05/28/2024
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