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Individual

DR. LISA M NUTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2002014342
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30976011
BLUE CROSS
MO
05
315972109
MO
01
410039208
RAILROAD MEDICARE
MO
01
431447951
TAX ID
MO
Enumeration date
02/07/2007
Last updated
10/06/2015
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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