Individual
LISA M GORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6240 N DURANGO DR STE 120, LAS VEGAS, NV 89149-3916
(954) 923-7440
(954) 923-1299
Mailing address
200 S PARK RD STE 200, HOLLYWOOD, FL 33021-8541
(954) 607-9826
(954) 923-1299
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
818245
NV
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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