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Individual

LISA LYN HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1832 OPAL AVE, LOCHBUIE, CO 80603-7787
(307) 689-4386
Mailing address
1832 OPAL AVE, LOCHBUIE, CO 80603-7787
(307) 689-4386

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
30762.1445
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30762.1445
STATE LICENSE
WY
01
APN.0993976-NP
STATE LICENSE
CO
01
RN.1656343
STATE LICENSE
CO
Enumeration date
10/19/2015
Last updated
09/26/2018
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