MRS. LISA M DISTIN LPN
NPI 1437374642
Licensed Practical Nurse in Tully, NY

Q: What is Lisa Distin's NPI number?

The NPI number for Lisa Distin is 1437374642. It was assigned to this individual provider in the NPPES registry on April 13, 2007.

Q: What is Lisa Distin's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Distin was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 13, 2007

4849 OTISCO RD, TULLY, NY 13159(315) 696-8592 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Mrs. Lisa M Distin Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. LISA M DISTIN LPN (NPI 1437374642) is an individual licensed practical nurse in Tully, New York, licensed in New York (238458-1) and active in the NPI registry since April 2007.

NPPES Registry Identity

NPI1437374642

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NameMRS. LISA M DISTINCredential: LPN

Location Address4849 OTISCO RDTully, NY 13159-3086

Mailing Address733 Middle RdOswego, NY 13126-5888 · (315) 343-2390 · Fax (315) 343-2390

Phone(315) 696-8592

Sole ProprietorYes

Enumeration DateApril 13, 2007

Last NPPES UpdateJuly 9, 2007

✔ NPI 1437374642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in NY · 238458-1

Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

4849 OTISCO RD, Tully, NY 13159

Open in Google Maps ↗

Other Identifiers 1

Medicaid01789642NY

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMY ELIZABETH GALLETTA LPN

Licensed Practical Nurse

4849 OTISCO RD
TULLY, NY 13159

Onondaga County (315) 696-8592

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Distin's NPI number?

The NPI number for Lisa Distin is 1437374642. It was assigned to this individual provider in the NPPES registry on April 13, 2007.

Where is Lisa Distin located?

Lisa Distin practices at 4849 Otisco Rd, Tully, NY 13159. The listed phone number is (315) 696-8592.

What is Lisa Distin's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Lisa Distin was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.