Provider Demographics
NPI:1437558756
Name:DUKES, LISA (RN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:DUKES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:SARAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NREMT-P
Mailing Address - Street 1:1061 HARMON AVE
Mailing Address - Street 2:WINN ARMY COMMUNITY HOSPITAL
Mailing Address - City:FORT STEWART
Mailing Address - State:GA
Mailing Address - Zip Code:31314-5641
Mailing Address - Country:US
Mailing Address - Phone:912-435-6721
Mailing Address - Fax:
Practice Address - Street 1:1061 HARMON AVE
Practice Address - Street 2:WINN ARMY COMMUNITY HOSPITAL
Practice Address - City:FORT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314-5641
Practice Address - Country:US
Practice Address - Phone:912-435-6721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAP0957978146L00000X
VA0001214745163WE0003X
GARN242616163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic