Provider Demographics
NPI:1275941882
Name:STRAWN, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:STRAWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 DAVIS AVE
Mailing Address - Street 2:A41
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-4151
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6 DAVIS AVE
Practice Address - Street 2:A41
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-4151
Practice Address - Country:US
Practice Address - Phone:347-372-8671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY526544163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse