Provider Demographics
NPI:1487975025
Name:KANE, LISA M (RN)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:M
Last Name:KANE
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 1:12660 ESPERANZA CT
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-8161
Mailing Address - Country:US
Mailing Address - Phone:720-733-9017
Mailing Address - Fax:
Practice Address - Street 1:12660 ESPERANZA CT
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-8161
Practice Address - Country:US
Practice Address - Phone:720-733-9017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO68293163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator