Individual
LISA A CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
820 RAVENHILL DR, SUITE 107, ATCHISON, KS 66002-9268
(913) 367-5496
(913) 674-2039
Mailing address
820 RAVENHILL DR, SUITE 107, ATCHISON, KS 66002-9268
(913) 367-5496
(913) 674-2039
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
10735
MN
363AS0400X
Surgical Physician Assistant
Primary
15-01594
KS
Other
Enumeration date
06/18/2010
Last updated
02/22/2013
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