Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | NPP37504 | RI |
NPI | 1003057563 |
---|---|
Provider Name | Lisa Pinkes |
First Address | East Greenwich, RI 02818-1608 |
Second Address | East Greenwich, RI 02818-1620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2009 |
Last Update Date | 15/03/2016 |