Dove, Lisa Dianne

Dove, Lisa Dianne is an individual health care provider with primary practice located at 619 19Th St S P 915, Birmingham AL 35233-1900. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Dove, Lisa Dianne can be contacted via phone (205) 975-0512.

Contact Information

Primary practice address
619 19Th St S P 915 Birmingham AL 35233-1900
Phone: (205) 975-0512
Fax: (205) 975-6404
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA491 Alabama
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 491 Alabama

Profile Details

NPI number 1720155476
LBN Legal business name Dove, Lisa Dianne
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated May 1st, 2013 - about 13 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 1720155476 NPPES
Alabama MEDICAID PAYEE #529916450
Alabama MEDICAID 009943016

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