| NPI | 1447854278 |
|---|---|
| Former Name | LISA SHIRL LANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 376G00000X Nursing Home Administrator |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2022-06-09 |