Individual
LISA A SENOUR-REBOULET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
15 W 19TH ST, ANDERSON, IN 46016-4306
(765) 646-8299
Mailing address
15 W 19TH ST, ANDERSON, IN 46016-4306
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71002736A
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71002736A
IN
Other
Enumeration date
09/24/2008
Last updated
11/01/2022
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