NPI: 1316455231 · GRANITEVILLE, SC 29829 · Family Nurse Practitioner · NPI assigned 01/12/2018
| Authorized Official | ROBERTSON, LISA (NURSE PRACTITIONER) |
| NPI Enumeration Date | 01/12/2018 |
Other providers sharing the same authorized official: ROBERTSON, LISA
| Provider | City | State | Total Paid |
|---|---|---|---|
| INDIANA IMMUNIZATION COALITION INC | INDIANAPOLIS | IN | $128K |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 15 | $1K |
| 2019 | 30 | $2K |
| Code | Description | Claims | Bene. Records | Total Paid |
|---|---|---|---|---|
| 99382 | 45 | 44 | $3K |