Lisa Marie Forkell

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

819395 Issued in NV

Practice address

480 Galletti Way BLDG 8
Sparks, NV 89431-5564

Phone

(775) 688-1633

Fax

(775) 688-1640

NPI assigned

Jun 29, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1801413570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 GALLETTI WAY BLDG 8",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894315564",
            "telephone_number": "755-688-1633",
            "fax_number": "775-688-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 GALLETTI WAY BLDG 8",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894315564",
            "telephone_number": "775-688-1633",
            "fax_number": "775-688-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORKELL",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NV",
            "license": "819395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Sparks, NV
• Providers in Sparks, NV by specialty
• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.