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Mrs. Lisa M Distin, LPN
Licensed Practical Nurse in Tully, New York
NPI 1437374642

Lisa M Distin is a Licensed Practical Nurse based in Oswego, NY. Lisa M Distin practices in Tully, NY and has the professional credentials of LPN. The NPI Number for Lisa M Distin is 1437374642 and holds a License No. 238458-1 (New York).

The current practice location address for Lisa M Distin is 4849 Otisco Rd, Tully, NY and can be reached out via phone at 315-696-8592.

Location: 4849 Otisco Rd, Tully, NY, 13126-5888
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1437374642
Provider Name
Lisa M Distin
Credential
LPN
Provider Entity Type
Individual
Gender
Female
Address
4849 Otisco Rd, Tully, NY, 13126-5888
Phone Number
315-696-8592
Fax Number
Provider Enumeration Date
04/13/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01789642 05 NY
institution
Provider Business Practice Location Address Details
Address
4849 Otisco Rd
City
Tully
State
New York
Zip
13159-3086
Phone Number
315-696-8592
Fax Number
person
Provider Business Mailing Address Details
Address
4849 Otisco Rd
City
Tully
State
New York
Zip
13159-3086
Phone Number
315-696-8592
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
238458-1 (New York)
Definition
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
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