| NPI | 1073582615 |
|---|---|
| Former Name | LISA TITTLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 8414) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN8418) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2023-03-07 |