Individual
LISA L. GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, ACCNS, FNP
Contact information
Practice address
620 N MAIN ST, HARRISON, AR 72601-2911
(870) 414-4076
Mailing address
PO BOX 7411626, CHICAGO, IL 60674-5626
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2018035616
MO
364SA2200X
Adult Health Clinical Nurse Specialist
2014024621
MO
364SP0200X
Pediatric Clinical Nurse Specialist
2014022682
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
07/10/2014
Last updated
03/13/2026
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