| NPI | 1417407230 |
|---|---|
| Former Name | LISA CORRELL EDWARDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25982) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 148858) |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2025-04-02 |