Stults, Lisa D

Stults, Lisa D is an individual health care provider with primary practice located at 1907 W Sycamore St , Kokomo IN 46901-5148. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Stults, Lisa D can be contacted via phone (765) 456-5900.

Contact Information

Primary practice address
1907 W Sycamore St Kokomo IN 46901-5148
Phone: (765) 456-5900
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71001805A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71001805A Indiana

Profile Details

NPI number 1033181599
LBN Legal business name Stults, Lisa D
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2006
Last updated Feb 9th, 2018 - about 8 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 1033181599 NPPES
Indiana Other 000000556066 ANTHEM-BCBS
Indiana MEDICAID 200522480 ANTHEM-BCBS
Indiana MEDICAID 1033181599 ANTHEM-BCBS

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