Provider Demographics
NPI:1073707832
Name:GIORDANO, LISA D (CFNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:D
Last Name:GIORDANO
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:D
Other - Last Name:HORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CFNP
Mailing Address - Street 1:3323 COTTON PRESS ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-8675
Mailing Address - Country:US
Mailing Address - Phone:919-610-9669
Mailing Address - Fax:
Practice Address - Street 1:2011 FALLS VALLEY DR STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3452
Practice Address - Country:US
Practice Address - Phone:919-208-2314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC118896363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2593283Medicare PIN