Individual
LISA PUTNAM HALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., P.N.P.
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
732596
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
21022
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20113310
NATIONAL PNP CERTIFICATION PEDIATRIC NURSING CERT BOARD
—
Enumeration date
11/28/2011
Last updated
10/17/2013
Update your record
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