Provider Demographics
NPI:1003057563
Name:PINKES, LISA (RNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:PINKES
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:GODIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNP
Mailing Address - Street 1:1341 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1608
Mailing Address - Country:US
Mailing Address - Phone:401-256-7573
Mailing Address - Fax:
Practice Address - Street 1:1285 S COUNTY TRL
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1620
Practice Address - Country:US
Practice Address - Phone:401-256-7573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP37504363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily