Individual
LISA ELLEN FAIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3 RIVERSIDE CIRCLE, ROANOKE, VA 24016
(540) 224-5170
(540) 985-9612
Mailing address
3 RIVERSIDE CIRCLE, ROANOKE, VA 24016
(540) 224-5170
(540) 985-9612
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
332601
NY
Other
Enumeration date
03/15/2006
Last updated
02/10/2011
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