Individual
MRS. LISA MARIE TELLIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
4300 SW 13TH ST, GAINESVILLE, FL 32608-4006
(352) 374-5600
Mailing address
4129 NW 166TH AVE, GAINESVILLE, FL 32653-7664
(352) 575-8969
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN 9309640
FL
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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