Individual
LISA R TRIPLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
140 SOUTH HOLLY STREET, MEDFORD, OR 97501
(541) 774-8200
(541) 774-7964
Mailing address
140 SOUTH HOLLY STREET, MEDFORD, OR 97501
(541) 774-8200
(541) 774-7964
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201403397-NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200510070
—
IN
Enumeration date
06/23/2006
Last updated
12/23/2014
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