| NPI | 1255188512 |
|---|---|
| Former Name | LISA MARIE HEYN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 10128) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 10128) |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2024-09-12 |