Individual
MRS. LISA A FOLDESI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3909 NEW VISION DR, FORT WAYNE, IN 46845-1725
(260) 469-6602
(260) 969-3065
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002067A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000693676
ANTHEM
IN
01
—
000000693681
ANTHEM
IN
05
—
200803000
—
IN
01
—
P00916058
MEDICARE RR
IN
Enumeration date
06/22/2006
Last updated
10/20/2022
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