Provider Demographics
NPI:1164810065
Name:PERDUE, LISA COLLINS (RN)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:COLLINS
Last Name:PERDUE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 SAVANNAH RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-0226
Mailing Address - Country:US
Mailing Address - Phone:302-645-3300
Mailing Address - Fax:302-645-3890
Practice Address - Street 1:424 SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-0226
Practice Address - Country:US
Practice Address - Phone:302-645-3300
Practice Address - Fax:302-645-3890
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0034930163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse