Organization
LISA HIESTAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA MICHELLE HIESTAND ARNP-C (ARNP-C)
(863) 844-1636
Entity
Organization
Contact information
Practice address
5929 COLONY PLACE DR, LAKELAND, FL 33813-2872
(863) 844-1636
Mailing address
5929 COLONY PLACE DR, LAKELAND, FL 33813-2872
(863) 844-1636
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
2011842
FL
Other
Enumeration date
11/10/2015
Last updated
11/10/2015
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