MRS. LISA LATHEM NP NPI 1710210794

NPI Information

NPI: 1710210794
Provider Name: MRS. LISA LATHEM, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
971 LAKELAND DR
SUITE 557
JACKSON, MS
ZIP 39216
Phone: (601) 200-4560
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MRS. Lisa Lathem, NP is a family nurse practitioner in Jackson, MS. MRS. Lisa Lathem, NP NPI is 1710210794. 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:

971 LAKELAND DR
SUITE 557
JACKSON, MS
ZIP 39216-643
Phone: (601) 200-4560
Fax: (601) 326-4632

The enumeration date for this NPI number is 9/9/2009 and was last updated on 4/30/2015.

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	R672106	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P01410915	OTHER	MISSISSIPPI	RAILROAD MEDICARE
2	302I505317	MEDICARE PIN	MISSISSIPPI
3	05721214	MEDICAID	MISSISSIPPI

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: 4/28/2024

NPI Synchronization or Removal

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