Blesse, Lisa Graham

Blesse, Lisa Graham is an individual health care provider with primary practice located at 1101 Highway 11 S , Ellisville MS 39437-4443. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Blesse, Lisa Graham can be contacted via phone (601) 477-5795.

Contact Information

Primary practice address
1101 Highway 11 S Ellisville MS 39437-4443
Phone: (601) 477-5795
Fax: (601) 477-5895
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R842124 Mississippi

Profile Details

NPI number 1508962101
LBN Legal business name Blesse, Lisa Graham
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508962101 NPPES
Mississippi MEDICAID 00125048

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