LISA JO SUWANAWONGSE FNP-BC NPI 1629546411

NPI Information

NPI: 1629546411
Provider Name: LISA JO SUWANAWONGSE, FNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
100 DR WARREN TUTTLE DR
HARRISBURG, IL
ZIP 62946
Phone: (618) 253-7671
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Lisa Jo Suwanawongse, FNP-BC is a family nurse practitioner in Harrisburg, IL. Lisa Jo Suwanawongse, FNP-BC NPI is 1629546411. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

100 DR WARREN TUTTLE DR
HARRISBURG, IL
ZIP 62946-718
Phone: (618) 253-7671
Fax: (618) 253-0474

The NPI 1629546411 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 11/9/2018 and was last updated on 11/9/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	209016422	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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