Individual
MRS. TERRI-ANN C LISA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
12 COURTNEY LN, BREWSTER, NY 10509-6158
(845) 278-2086
Mailing address
12 COURTNEY LN, BREWSTER, NY 10509-6158
(845) 278-2086
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
521999-1
NY
Other
Enumeration date
12/29/2006
Last updated
07/08/2007
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