Individual
LISA EARLYWINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 254-4000
(386) 231-3695
Mailing address
PO BOX 100254, GAINESVILLE, FL 32610-0254
(386) 254-4000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP3200322
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
309101500
—
FL
01
—
PENDING
BCBS
FL
05
—
PENDING
—
FL
Enumeration date
04/04/2008
Last updated
11/21/2023
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