LISA DUBOSE (NPI# 1316394364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316394364 |
| Entity Type | Individual |
| Full Name | LISA DUBOSE |
| Credential | RN |
| Practice Address |
350 Salem Rd Ste 1 Conway AR 72034-6166 |
| Mailing Address |
2400 S 48th St Springdale AR 72762-6683 |
| Practice Telephone | 5013368300 |
| Practice Fax Number | 5013295508 |
| Mailing Telephone | 4797502020 |
| Mailing Fax Number | 4797504843 |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2020-04-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
R032817 | AR | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 224468795 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861549271 | Lisa A Dubose | Nurse Practitioner | 200 Patewood Dr, Suite A300, Greenville, SC 29615-3593 | 2007-01-05 |
| Street Address |
350 SALEM RD STE 1 |
| City | CONWAY |
| State | AR |
| Zip Code | 72034-6166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376518589 | Atif M Akhtar | Psychiatry & Neurology | 350 Salem Rd Ste 1, Conway, AR 72034 | 2006-02-21 |
| 1942846456 | Briana Gean Pope | Counselor | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2019-11-19 |
| 1689215717 | Traci Temples | Case Manager/Care Coordinator | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2019-09-30 |
| 1417506197 | Haley Jehree Glover | Counselor | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2019-09-05 |
| 1548814882 | Lindsey Paige Lamb | Case Manager/Care Coordinator | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2019-07-25 |
| 1861979494 | William Kyle Purcell | Counselor | 350 Salem Rd Ste 1, Conway, AR 72034 | 2018-07-26 |
| 1619474772 | Ashley Jane Pruitt | Registered Nurse | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2018-04-06 |
| 1922519362 | Katy Carnahan | Case Manager/Care Coordinator | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2017-10-12 |
| 1821508797 | Leslie Spurgers | Case Manager/Care Coordinator | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2017-10-05 |
| 1922517440 | Katherine Baxter | Case Manager/Care Coordinator | 350 Salem Rd Ste 1, Conway, AR 72034-6166 | 2017-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013563758 | Shelby M Perez | Case Manager/Care Coordinator | 3240 Stermer Rd, Conway, AR 72034 | 2019-08-16 |
| 1467932772 | Faith J Parfait | Licensed Practical Nurse | 1352 Watkins St, Conway, AR 72034 | 2018-08-16 |
| 1043790611 | David Adam Steinfeld | Nurse Practitioner | 855 S German Ln Ste 1, Conway, AR 72034 | 2018-08-14 |
| 1245728484 | Conway Behavioral Health, LLC | Psychiatry & Neurology | 2255 Sturgis Rd, Conway, AR 72034 | 2018-04-24 |
| 1972007292 | Eldercare of Arkansas IIi, Inc. | Assisted Living Facility | 1306 S. Donaghey, Conway, AR 72034 | 2018-03-21 |
| 1528561404 | Kouhei Kobayashi | Specialist/Technologist | 2201 Moix Blvd., Apt. 908, Conway, AR 72034 | 2018-03-16 |
| 1780191015 | Sydnie Thessing | Nurse Practitioner | 605 Dave Ward Drive #105, Conway, AR 72034 | 2018-01-09 |
| 1508371865 | Ebony Latreace Charleston | Case Manager/Care Coordinator | 3240 Stermer Road, Conway, AR 72034 | 2017-12-08 |
| 1689190647 | Denise Annette Aikman | Dentist | 1210 Hogan Lane, Suite 200, Conway, AR 72034 | 2017-08-21 |
| 1134669138 | Hortons Orthotic Lab, Inc. | Prosthetic/Orthotic Supplier | 635 Dave Ward, Suite 103, Conway, AR 72034 | 2017-02-24 |
| Find all providers in zip 72034 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235773326 | Edith Bostic | Registered Nurse | 409 Paul St, Conway, SC 29527-5823 | 2019-10-31 |
| 1598851149 | Rosalie Farace | Registered Nurse | 164 Waccamaw Medical Park Drive, Conway, SC 29526 | 2006-10-04 |
| 1083251771 | Susan Scott Church | Registered Nurse | 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 | 2019-12-02 |
| 1881158764 | Beth Ann Anrold | Registered Nurse | 25 W Main St, Conway, NH 03818-6142 | 2019-01-25 |
| 1598108789 | Donna Holt | Registered Nurse | 350 Salem Rd, Suite 1, Conway, AR 72034-7525 | 2013-04-08 |
| 1629247069 | Caroline Groom | Registered Nurse | 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 | 2008-02-28 |
| 1154422616 | Paulette W Hemingway | Registered Nurse | 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 | 2006-09-26 |
| 1962424119 | Bonnie B Corrigan | Registered Nurse | 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 | 2006-07-24 |
| 1235155011 | Sarah Gamble Reynolds | Registered Nurse | 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 | 2006-07-14 |
| 1982620795 | Gary Curtis Chandler | Registered Nurse | 164 Waccamaw Medical Park Dr, Conway, SC 29526-8903 | 2006-07-14 |
| Find all providers in CONWAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.