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Contact Information

LISA M LOGAN, PA-C
825 S MAIN ST.
TONOPAH, NV89049
 Phone: 775-982-8255
 Fax: 775-982-3900
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for LISA M LOGAN · (Female)

NPI Number 1114098464
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 11/10/2006
Last updated 08/23/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • NV License # PA1023
Hospital affiliation(s)
  • CARSON TAHOE REGIONAL MEDICAL CENTER - (Acute Care)
    1600 MEDICAL PARKWAY
    CARSON CITY, NV 89703
  • RENOWN REGIONAL MEDICAL CENTER - (Acute Care)
    1155 MILL STREET
    RENO, NV 89502
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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