Individual
DR. LISA ANN DURETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6375 W CHARLESTON BLVD STE A-100, LAS VEGAS, NV 89146-1139
(702) 253-0818
(702) 253-9625
Mailing address
3016 W CHARLESTON BLVD, STE 100, LAS VEGAS, NV 89102-1973
(702) 780-7118
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
10869
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100504475
—
NV
Enumeration date
09/21/2006
Last updated
06/02/2020
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