Individual
MRS. LISA RENE BURNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, CPNP-PC
Contact information
Practice address
34520 BOB WILSON DR, SAN DIEGO, CA 92134-2098
(619) 532-8819
(619) 532-9582
Mailing address
34520 BOB WILSON DR, SAN DIEGO, CA 92134-2098
(619) 532-8819
(619) 532-9582
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95007606
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
10/04/2017
Last updated
10/04/2017
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