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1518912369
LYZA TENNILLE GAINES
FORT PAYNE, AL
NPI
1518912369
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: AL 1-091459)
Enumeration Date
2006-05-23
Last Update Date
2012-09-26
Business Address
-- LYZA TENNILLE GAINES CRNP
415 MEDICAL CENTER DR SW
FORT PAYNE, AL 35968-3421
Phone number: 256-997-2820
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Mailing Address
-- LYZA TENNILLE GAINES CRNP
415 MEDICAL CENTER DR SW
FORT PAYNE, AL 35968-3421
Phone number: 256-997-2820
Copy
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