Ms. Lisa Marie Polhamus
Nurse Practitioner - Neonatal
501 6th Ave S
St Petersburg
, Florida 33701
Ms. Lisa Marie Polhamus
Nurse Practitioner - Neonatal
501 6th Ave S
St Petersburg
, Florida 33701
(727) 767-4391
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About
Features
Specialties
- Nurse Practitioner - Neonatal
Languages spoken
- English
Location
First Address
- Ms. Lisa Marie Polhamus
- 501 6th Ave S
- St Petersburg, FL
- Zip : 33701-4634
- Fax : (727) 767-4391
- Phone : (727) 767-4313
Second Address
- Ms. Lisa Marie Polhamus
- 501 6th Ave S
- St Petersburg, FL
- Zip : 33701
- Fax : (727) 767-4391
- Phone : (727) 767-4313
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LN0000X | Nurse Practitioner - Neonatal | ARNP9481675 | FL |
National Provider Identifier
| NPI | 1114188604 |
|---|---|
| Provider Name | Ms. Lisa Marie Polhamus |
| First Address | St Petersburg, FL 33701-4634 |
| Second Address | St Petersburg, FL 33701 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/06/2008 |
| Last Update Date | 20/06/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 024415700 | (05) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.