| Doctor Name: | LISA SYTSMA |
| NPI Number: | 1770937682 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | A133377 |
| Business Practice Address: | 100 E Jefferson St Prairie City, IA - 502287709 |
| Business Phone Number: | 5159942617 |
| Business Fax Number: | |
| Mailing Address: | 100 E Jefferson St, PRAIRIE CITY |
| State: | IA |
| Postal Code: | 502287709 |
| Phone Number: | 5159942617 |
| Fax Number: | |
| NPI Enumeration Date: | 04/17/2016 |
| NPI Last Update Date: | 04/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SF0001X |
| License Number: | A133377 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Family Health |
| Taxonomy Definition: | |