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Individual

MS. LISA COMERFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
285 W 12TH ST, STE. 205, PERU, IN 46970-1653
(765) 473-6400
Mailing address
285 W 12TH ST, STE. 205, PERU, IN 46970-1653
(765) 473-6400

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001007A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100351380
IN
Enumeration date
04/28/2006
Last updated
03/29/2012
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