Agan, Lisa K
Agan, Lisa K is an individual health care provider with primary practice located at 1100 W. 21St , Clovis NM 88101. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Agan, Lisa K can be contacted via phone (575) 769-2345.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | New Mexico |
Profile Details
| NPI number | 1144762899 |
|---|---|
| LBN Legal business name | Agan, Lisa K |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 11th, 2016 |
| Last updated | Mar 13th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144762899 | NPPES |
| New Mexico | MEDICAID | 58384031 |
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