Provider Demographics
NPI:1750153276
Name:EDLER, LISA CHRISTINE (RN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:CHRISTINE
Last Name:EDLER
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 1:5314 W 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-2304
Mailing Address - Country:US
Mailing Address - Phone:509-572-0897
Mailing Address - Fax:
Practice Address - Street 1:6011 W 10TH PL
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-1400
Practice Address - Country:US
Practice Address - Phone:509-222-7703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60220008163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool