Lisa Marie Park, FNP-BC

NPI #1639944382 in Triadelphia, West Virginia

Provider Information

NPI Number: 1639944382
Entity Type: Individual
Name: Lisa Marie Park, FNP-BC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Family Medicine
Credential: FNP-BC
Enumeration Date: Nov 21, 2023
Last Updated: Nov 21, 2023

Practice Location

Address: 4509 NATIONAL RD
City: Triadelphia
State: West Virginia
ZIP Code: 26059-2013
Phone: (304) 639-0873

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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