Individual provider · Type 1 NPI

Kenneth Paolo Dagdag Lising, MSN, APRN, FNP-C

Family Nurse Practitioner · Fullerton, CA

NPI number 1003465105 Active

Practice location

2141 N Harbor Blvd Ste 25000
Fullerton, CA 92835-3830

Mailing address

10283 Jasmine Ct
Stanton, CA 90680-8505

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X95012739 (CA)

Family Nurse Practitioner: Definition to come...

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About NPI 1003465105

Kenneth Paolo Dagdag Lising, MSN, APRN, FNP-C's National Provider Identifier is 1003465105, issued on Sep 11, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Fullerton, CA. The record was last updated on Nov 11, 2021.