Provider Demographics
NPI:1356601900
Name:MARUHN, LISA MARIE (LVN)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIE
Last Name:MARUHN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 N MANOR ST
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-2817
Mailing Address - Country:US
Mailing Address - Phone:559-901-7525
Mailing Address - Fax:559-733-8338
Practice Address - Street 1:630 N MANOR ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2817
Practice Address - Country:US
Practice Address - Phone:559-901-7525
Practice Address - Fax:559-733-8338
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN188354164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse