MEDICARE: MS. LISA G RORMAN M.ED., M.D.R., J.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1578856498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LISA G RORMAN M.ED., M.D.R., J.D.

Provider Business Mailing Address
First Line	:	5940 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2506
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5940 S RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2506
Country	:	US
Telephone Number	:	888-531-8385
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2011
Last Update Date	:	12/07/2022

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