Provider Demographics
NPI:1851417968
Name:ALLRED, LISA KAY (RN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:KAY
Last Name:ALLRED
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 KIMBERLY DR
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-5301
Mailing Address - Country:US
Mailing Address - Phone:541-273-6465
Mailing Address - Fax:541-273-7518
Practice Address - Street 1:1612 KIMBERLY DR
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-5301
Practice Address - Country:US
Practice Address - Phone:541-273-6465
Practice Address - Fax:541-273-7518
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health