Organization
LIGHTHOUSE FAMILY MEDICINE, PLLC
Active
Other names
Lisa C. Nelson, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA CARRAWAY NELSON MD (OWNER)
(252) 948-1393
Entity
Organization
Contact information
Practice address
1005 BROWN ST, WASHINGTON, NC 27889-4670
(252) 948-1393
Mailing address
1005 BROWN ST, WASHINGTON, NC 27889-4670
(252) 948-1393
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
207-00955
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146HH
BLUE CROSS
NC
05
—
5908673
—
NC
Enumeration date
10/16/2008
Last updated
10/16/2008
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