Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP60282467 | WA |
N | 363LC1500X | Nurse Practitioner - Community Health | AP60282467 | WA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | AP60282467 | WA |
NPI | 1578808465 |
---|---|
Provider Name | Lisa Ann Jones |
First Address | Yakima, WA 98902-2715 |
Second Address | Yakima, WA 98902-4880 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2012 |
Last Update Date | 08/04/2019 |