Provider Demographics
NPI:1548631781
Name:GIL, LISA MARIE (RN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:GIL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6315 TRINIDAD AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-6001
Mailing Address - Country:US
Mailing Address - Phone:661-472-7292
Mailing Address - Fax:
Practice Address - Street 1:4813 COFFEE RD STE 200
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-9473
Practice Address - Country:US
Practice Address - Phone:661-664-0252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95027079363L00000X
CA781571163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse