Provider Demographics
NPI:1306918677
Name:VAN PARIS, LISA LOUISE (RNC)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:LOUISE
Last Name:VAN PARIS
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15002 N 32ND ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4441
Mailing Address - Country:US
Mailing Address - Phone:480-419-5623
Mailing Address - Fax:480-419-5625
Practice Address - Street 1:15002 N 32ND ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4441
Practice Address - Country:US
Practice Address - Phone:480-419-5623
Practice Address - Fax:480-419-5625
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN086750163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool