Individual
LISA NANNIE
Active
Individual
LISA NANNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209001338
IL
363LP2300X
Primary Care Nurse Practitioner
209001338
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050884
HEALTH ALLIANCE
IL
01
—
472307
HEALTHLINK
IL
01
—
7215059
BCBS PPO
IL
01
—
IL01W1
JOHN DEERE
IL
Enumeration date
07/31/2006
Last updated
10/12/2023
Update your record
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