Individual
MS. LISA ANNE HEIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2020 W CROFT CIR APT A, SPARTANBURG, SC 29302-3075
(919) 641-7517
Mailing address
2020 W CROFT CIR APT A, SPARTANBURG, SC 29302-3075
(919) 641-7517
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
52096
SC
Other
Enumeration date
10/09/2021
Last updated
10/09/2021
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