Provider Demographics
NPI:1730897448
Name:HEMPHILL, LISA MONIQUE (LVN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MONIQUE
Last Name:HEMPHILL
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MONIQUE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3810 ROSIN CT STE 180
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1658
Mailing Address - Country:US
Mailing Address - Phone:916-283-8259
Mailing Address - Fax:
Practice Address - Street 1:3810 ROSIN CT STE 180
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1658
Practice Address - Country:US
Practice Address - Phone:916-283-8259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA208996164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse