Lisa M Deese, CNA

Individual provider Active NPI Home Health Aide · Cottondale, FL

NPI 1225811516 · NPPES record last updated Aug 18, 2023

Key facts

NPI
1225811516
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Aide 374U00000X
Practice address
2828 Deese LN
Cottondale, FL 32431-7356
Phone
(850) 693-5135
NPI assigned
Aug 18, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide
Group: 193400000X SINGLE SPECIALTY GROUP
374U00000X Yes

Addresses

Primary practice location

2828 Deese LN
Cottondale, FL 32431-7356

Mailing address

2828 Deese LN
Cottondale, FL 32431-7356
Phone (850) 693-5135

Other providers in Cottondale, FL

All providers in Cottondale, FL · Home Health Aide in Florida

Sources for this page

Verify at the official NPI Registry.