Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | NP16396 | CA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 9318004 | FL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN1005286 | DC |
N | 363LF0000X | Nurse Practitioner - Family Medicine | SP012851 | PA |
NPI | 1003834771 |
---|---|
Provider Name | Mrs. Lisa Ann Hacker |
First Address | San Francisco, CA 94111-3723 |
Second Address | Washington, DC 20001-4545 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 19/06/2020 |