Earlywine, Lisa

Earlywine, Lisa is an individual health care provider with primary practice located at 303 N Clyde Morris Blvd , Daytona Beach FL 32114-2709. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Earlywine, Lisa can be contacted via phone (386) 254-4000.

Contact Information

Primary practice address
303 N Clyde Morris Blvd Daytona Beach FL 32114-2709
Phone: (386) 254-4000
Fax: (386) 231-3695
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X ARNP3200322 Florida

Profile Details

NPI number 1750554358
LBN Legal business name Earlywine, Lisa
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2008
Last updated Nov 21st, 2023 - about last year

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 1750554358 NPPES
Florida Other PENDING BCBS
Florida MEDICAID PENDING BCBS
Florida MEDICAID 309101500 BCBS

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