Gilmore, Lisa L.

Gilmore, Lisa L. is an individual health care provider with primary practice located at 620 N Main St , Harrison AR 72601-2911. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Gilmore, Lisa L. can be contacted via phone (870) 414-4076.

Contact Information

Primary practice address
620 N Main St Harrison AR 72601-2911
Phone: (870) 414-4076
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X 2014024621 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 364SP0200X 2014022682 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2018035616 Missouri

Profile Details

NPI number 1629484647
LBN Legal business name Gilmore, Lisa L.
Credentials DNP, ACCNS, FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2014
Last updated Feb 28th, 2022 - about 4 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 1629484647 NPPES
Missouri MEDICAID PENDING

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