Most Relevant Information
Provider Data
| NPI Number: | 1003055955 |
| Provider Name: | LISSA WEST FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 163WP0200X |
| Specialty: | Registered Nurse |
| License Number: | 115113 R.N. |
Most Important Dates
| Enumeration Date: | 02/17/2009 |
| Last Updated: | 09/21/2018 |
Provider Practice Location
3606 MACLAY BLVD STE 102
TALLAHASSEE
FL
32312
Practice Location Phone/Fax
| Phone: | 8058771162 |
| Fax: | 8506715009 |
Provider Mailing Location
3606 MACLAY BLVD STE 102
TALLAHASSEE
FL
32312
Provider Mailing Phone/Fax
| Phone: | 8058771162 |
| Fax: | 8506715009 |