Doctor Name: | MRS. LISA J BOOKER |
NPI Number: | 1053528778 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | AO1659 |
Business Practice Address: | 260 West Broad Street Lepanto, AR - 723540000 |
Business Phone Number: | 8704753180 |
Business Fax Number: | 8704753185 |
Mailing Address: | 260 West Broad Street, P.o. Box 723 LEPANTO |
State: | AR |
Postal Code: | 723540723 |
Phone Number: | 8704753180 |
Fax Number: | 8704753185 |
NPI Enumeration Date: | 05/16/2007 |
NPI Last Update Date: | 03/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AO1659 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |