Provider Demographics
NPI:1225304421
Name:WALKER-VISCHER, LISA ANN (RN, CNS)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:WALKER-VISCHER
Suffix:
Gender:F
Credentials:RN, CNS
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:VISCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, CNS
Mailing Address - Street 1:1166 HOLMES AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-7108
Mailing Address - Country:US
Mailing Address - Phone:408-315-5800
Mailing Address - Fax:408-371-8342
Practice Address - Street 1:1166 HOLMES AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-7108
Practice Address - Country:US
Practice Address - Phone:408-315-5800
Practice Address - Fax:408-371-8342
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN384682163WP0200X
CA813364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics