Female

Lisa M. Licciardi

Nurse's Aide in Penrose, NC(View on Map)

Full Name

Lisa Marie Licciardi

NPI Number

1043506132

NPI Type

Individual Provider

Gender

Female

Enumeration Date

06/27/2011

Specialties

(Taxonomies)

Code

376K00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

508 ELM BEND RD
82 HILLSIDE RD

City

Brevard
Penrose

State

NC
NC

Postal Code

28712-9577
28766-8783

Country

US
US

Telephone Number

N/A
(828) 877-4076

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/27/2011

Provider Address