National Provider Identifier
Lisa Moon, REGISTERED NURSE
Lisa Moon, REGISTERED NURSE is listed in the NPPES registry with a primary specialty of Registered Nurse in Palmyra, NY and a listed phone number of (315) 573-0203.
Profile Overview
- NPI
- 1164046769
- Provider Type
- Individual
- Primary Specialty
- Registered Nurse
- Enumeration Date
- May 31, 2020
- Last Updated
- May 31, 2020
Practice Location
- 2584 Maple Ave
- Palmyra, NY 14522-9372
Phone: (315) 573-0203
Specialties
- Registered Nurse (163W00000X)
Full Record
- NPI
- 1164046769
- Entity Type
- Individual
- Last Name
- Moon
- First Name
- Lisa
- Name Prefix
- Mrs.
- Credential
- REGISTERED NURSE
- Mailing Street Address
- 2584 Maple Ave
- Mailing City
- Palmyra
- Mailing State
- NY
- Mailing ZIP Code
- 14522-9372
- Mailing Country
- US
- Mailing Phone
- (315) 573-0203
- Practice Street Address
- 2584 Maple Ave
- Practice City
- Palmyra
- Practice State
- NY
- Practice ZIP Code
- 14522-9372
- Practice Country
- US
- Practice Phone
- (315) 573-0203
- Enumeration Date
- May 31, 2020
- Last Updated
- May 31, 2020
- Sex
- Female
- Sole Proprietor
- Yes
- Taxonomy Group 1
- 193400000X Single Specialty Group
- Certification Date
- May 31, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Registered Nurse (163W00000X)