Most Relevant Information
Provider Data
| NPI Number: | 1003181132 |
| Provider Name: | LISA JOI OETJEN APRN, FNP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 3007393 |
Most Important Dates
| Enumeration Date: | 03/22/2012 |
| Last Updated: | 03/14/2017 |
Provider Practice Location
4787 ALBEN BARKLEY DR
PADUCAH
KY
420016789
Practice Location Phone/Fax
| Phone: | 2704429461 |
| Fax: | 2704410079 |
Provider Mailing Location
510 LINCOLN DR
HERRIN
IL
629486334
Provider Mailing Phone/Fax
| Phone: | 6189976800 |
| Fax: | 6189971187 |