NPI | 1184819088 |
---|---|
Former Name | LISA KATHLEEN COLOSIMO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5003375) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024169504) |
363LA2200X Nurse Practitioner, Adult Health (Licence: SC 3651) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: NH 084951-23) | |
Enumeration Date | 2007-09-13 |
Last Update Date | 2023-12-26 |