Provider Demographics
NPI:1639369747
Name:LIS, BARBARA E (RN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:E
Last Name:LIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:E
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22 DRAGON CIR
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1302
Mailing Address - Country:US
Mailing Address - Phone:413-527-9402
Mailing Address - Fax:
Practice Address - Street 1:1727 NORTHAMPTON ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-1919
Practice Address - Country:US
Practice Address - Phone:413-532-0926
Practice Address - Fax:413-532-0928
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA97170163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse