Individual
MRS. LISA RENEE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2620 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3396
(573) 785-7721
Mailing address
208 HUNTER RD, POPLAR BLUFF, MO 63901-7486
(573) 778-9214
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
146572
MO
Other
Enumeration date
12/06/2011
Last updated
12/06/2011
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