Active NPI
Lisa Ann Nedlan, R.N.
- Ambulatory Care Registered Nurse
- Eureka, CA
National Provider Identifier
1376882589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Registered Nurse
- License
- 308613
- Practice address
- 6442 Elk River Rd
Eureka, CA 95503-9607 - Phone
- (707) 442-7312
- NPI assigned
- Feb 7, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Registered Nurse | 163WP2201X | 308613 | CA | Primary |
Addresses
Primary practice location
6442 Elk River Rd
Eureka, CA 95503-9607
Mailing address
6442 Elk River Rd
Eureka, CA 95503-9607
Phone (707) 442-7312
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 308613 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360195200000",
"number": "1376882589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6442 ELK RIVER RD",
"city": "EUREKA",
"state": "CA",
"postal_code": "955039607",
"telephone_number": "707-442-7312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6442 ELK RIVER RD",
"city": "EUREKA",
"state": "CA",
"postal_code": "955039607",
"telephone_number": "707-442-7312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEDLAN",
"first_name": "LISA",
"middle_name": "ANN",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-02-07",
"last_updated": "2013-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "163WP2201X",
"taxonomy_group": "",
"desc": "Registered Nurse, Ambulatory Care",
"state": "CA",
"license": "308613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.