Individual
LISA DAWN ECKHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
085004016
IL
363AM0700X
Medical Physician Assistant
10001357A
IN
363AM0700X
Medical Physician Assistant
2015007864
MO
363AM0700X
Medical Physician Assistant
Primary
2550
OK
Other
Enumeration date
11/05/2011
Last updated
08/29/2019
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