Provider Demographics
NPI:1649787193
Name:MCGINNETT, LISA RENEE
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:RENEE
Last Name:MCGINNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2686 PATTERSON RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8817
Mailing Address - Country:US
Mailing Address - Phone:970-298-6420
Mailing Address - Fax:970-298-6497
Practice Address - Street 1:2686 PATTERSON RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8817
Practice Address - Country:US
Practice Address - Phone:970-298-6420
Practice Address - Fax:970-298-6497
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator