Individual
LISA E COLWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1017 N MAIN ST, SIKESTON, MO 63801-5043
(573) 472-6030
(573) 472-6029
Mailing address
1017 N MAIN ST, SIKESTON, MO 63801-5043
(573) 472-6030
(573) 472-6029
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
081070
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
428896013
—
MO
Enumeration date
10/12/2006
Last updated
08/28/2013
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