| NPI | 1396840211 |
|---|---|
| Former Name | LISA ANN HOMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NM 54024) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 368977-4405) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2019-11-24 |