Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | E4325 | CA |
NPI | 1427093756 |
---|---|
Provider Name | Miss Lisa N Nelms |
First Address | Santa Barbara, CA 93109-1327 |
Second Address | Solvang, CA 93463-3224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2006 |
Last Update Date | 02/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
485511 | (02) | CA |
E4325 | (02) | CA |