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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 3 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.

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Identifiers

StateTypeNumberIssuer
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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