Provider Demographics
NPI:1982986964
Name:DEPPERMAN, LISA LINAKIS (RN)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:LINAKIS
Last Name:DEPPERMAN
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 1:130 EAST ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-1357
Mailing Address - Country:US
Mailing Address - Phone:607-433-8249
Mailing Address - Fax:607-433-4642
Practice Address - Street 1:130 EAST ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-1357
Practice Address - Country:US
Practice Address - Phone:607-433-8249
Practice Address - Fax:607-433-4642
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY418765-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool