Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 140371 | MO |
NPI | 1427109115 |
---|---|
Provider Name | Lisa B Kail |
First Address | Cape Girardeau, MO 63703-6393 |
Second Address | Cape Girardeau, MO 63703-6393 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 07/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
421499401 | (05) | MO |
5719955 | FIRST HEALTH (01) | MO |
763717 | HEALTHLINK (01) | MO |