Colasurdo, Lisa B
Colasurdo, Lisa B is an individual health care provider with primary practice located at 3021 Reidville Rd , Spartanburg SC 29301-5643. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Colasurdo, Lisa B can be contacted via phone (864) 576-9201.Contact Information
Primary practice address
3021 Reidville Rd
Spartanburg SC 29301-5643
Phone: (864) 576-9201
Fax: (864) 576-6584
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | APN 875 | South Carolina |
Profile Details
| NPI number | 1447246616 |
|---|---|
| LBN Legal business name | Colasurdo, Lisa B |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 23rd, 2005 |
| Last updated | Aug 18th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447246616 | NPPES |
| South Carolina | Other | P00695569 | RR MEDICARE PTAN |
| South Carolina | Other | GP4988 | RR MEDICARE PTAN |
| South Carolina | MEDICAID | NP0491 | RR MEDICARE PTAN |
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