| NPI | 1407259039 |
|---|---|
| Former Name | LISA K MCCOLLUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: OH 20141298) |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2014-09-26 |