Provider Demographics
NPI:1578923090
Name:CURTIS, LISA (RN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:CURTIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CLARA
Other - Middle Name:LISA
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:2868 NW MONTEREY PL
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-3436
Mailing Address - Country:US
Mailing Address - Phone:541-243-5225
Mailing Address - Fax:
Practice Address - Street 1:2868 NW MONTEREY PL
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3436
Practice Address - Country:US
Practice Address - Phone:541-243-5225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-25
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR092007029RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health