Doctor Name: | MRS. LISA JAYNE GAUVIN |
NPI Number: | 1023401650 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | AP127089 |
Business Practice Address: | 3430 Lakeview Pkwy Rowlett, TX - 750883367 |
Business Phone Number: | 9724752597 |
Business Fax Number: | |
Mailing Address: | 3430 Lakeview Pkwy, ROWLETT |
State: | TX |
Postal Code: | 750883367 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/06/2015 |
NPI Last Update Date: | 06/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP127089 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |