Individual
LISA W MAGLIOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1010 S POLK ST, COVINGTON, LA 70433-2474
(985) 871-5975
(985) 871-5970
Mailing address
1010 S POLK ST, COVINGTON, LA 70433-2474
(985) 871-5975
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
100124
LA
363LF0000X
Family Nurse Practitioner
Primary
200520
LA
Other
Enumeration date
10/03/2018
Last updated
07/15/2022
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