Individual
LISA BACKE X
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7055 SAMUEL MORSE DR, SUITE 200, COLUMBIA, MD 21046-3439
(410) 910-6700
Mailing address
7055 SAMUEL MORSE DR, SUITE 200, COLUMBIA, MD 21046-3439
(410) 910-6700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001201705
VA
Other
Enumeration date
11/17/2015
Last updated
11/17/2015
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