Provider Demographics
NPI:1013072859
Name:BATCHELOR, LISA ELAINE (FNP, C, MSN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ELAINE
Last Name:BATCHELOR
Suffix:
Gender:F
Credentials:FNP, C, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1438 W 122ND ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90047-5309
Mailing Address - Country:US
Mailing Address - Phone:323-418-0804
Mailing Address - Fax:
Practice Address - Street 1:23517 MAIN ST
Practice Address - Street 2:# 103
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-5251
Practice Address - Country:US
Practice Address - Phone:310-834-5388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 15046363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily