Lisa Denise Mullally, D.O.
Family Medicine in Crown Point, IN. Individual provider (NPI-1).
NPI number1861462012
StatusActive
Last updated in NPPESMar 25, 2019
Details
- NPI
- 1861462012
- Entity type
- Individual (NPI-1)
- Name
- Lisa Denise Mullally
- Credential
- D.O.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 23, 2006
- Last updated
- Mar 25, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 02003098 | IN | Yes |
Other names
- Lisa Denise Novak (Former Name)
Practice location
11275 Delaware PkwyCrown Point, IN 46307-7812
Phone 219-779-8735 · Fax 877-715-2312
Mailing address
Po Box 108Crown Point, IN 46308-0108
Phone 219-779-8735 · Fax 877-715-2312
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