Individual
MRS. LISA N PIPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
207 N TOWNLINE RD STE 104, LAGRANGE, IN 46761-1325
(260) 463-9360
(260) 463-9374
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01041550A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000679262
ANTHEM
IN
05
—
100468460
—
IN
Enumeration date
07/11/2006
Last updated
03/21/2023
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