Provider Demographics
NPI:1295381853
Name:TOONE, LISA RICHARDS (FNP-C)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:RICHARDS
Last Name:TOONE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 W 800 N
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84321-7837
Mailing Address - Country:US
Mailing Address - Phone:435-152-8175
Mailing Address - Fax:
Practice Address - Street 1:870 W 800 N
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84321-7837
Practice Address - Country:US
Practice Address - Phone:435-752-8175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT349202-4405363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care