Dubose, Lisa

Dubose, Lisa is an individual health care provider with primary practice located at 350 Salem Rd Ste 1 , Conway AR 72034-6166. She recently has only one registered license in Nursing Service Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Dubose, Lisa can be contacted via phone (501) 336-8300.

Contact Information

Primary practice address
350 Salem Rd Ste 1 Conway AR 72034-6166
Phone: (501) 336-8300
Fax: (501) 329-5508
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X R032817 Arkansas

Profile Details

NPI number 1316394364
LBN Legal business name Dubose, Lisa
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2016
Last updated Apr 30th, 2020 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316394364 NPPES
Arkansas MEDICAID 224468795

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