Individual
LISA KATHRYN HUMBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11631 SALTER COLVIN RD, WOLCOTT, NY 14590-9376
(315) 594-3100
(315) 594-6235
Mailing address
11631 SALTER COLVIN RD, WOLCOTT, NY 14590-9376
(315) 594-3100
(315) 594-6235
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
407913-1
NY
Other
Enumeration date
11/22/2011
Last updated
11/22/2011
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