Nutt, Lisa M

Nutt, Lisa M is an individual health care provider with primary practice located at 6000 N Oak Trfy Ste 101 , Gladstone MO 64118-5176. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Nutt, Lisa M can be contacted via phone (816) 454-1030.

Contact Information

Primary practice address
6000 N Oak Trfy Ste 101 Gladstone MO 64118-5176
Phone: (816) 454-1030
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2002014342 Missouri

Profile Details

NPI number 1780724138
LBN Legal business name Nutt, Lisa M
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2007
Last updated Oct 6th, 2015 - about 9 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 1780724138 NPPES
Missouri Other 410039208 RAILROAD MEDICARE
Missouri Other 30976011 RAILROAD MEDICARE
Missouri MEDICAID 315972109 RAILROAD MEDICARE
Missouri Other 431447951 RAILROAD MEDICARE

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