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Individual

MRS. LISA L SPILLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2605 KENUTCKY AVE, SUITE 3 BLDG 3, PADUCAH, KY 42003
(270) 443-7534
(270) 442-0309
Mailing address
2605 KENUTCKY AVE, SUITE 3 BLDG 3, PADUCAH, KY 42003-3804
(270) 443-7534
(270) 442-0309

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3002247
KY
363LF0000X
Family Nurse Practitioner
3002247
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
78001369
KY
Enumeration date
05/26/2005
Last updated
12/03/2020
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