Provider Demographics
NPI:1376082891
Name:FALKNER, LISA (CLB(CBI), LMT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:FALKNER
Suffix:
Gender:F
Credentials:CLB(CBI), LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 VINE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1431
Mailing Address - Country:US
Mailing Address - Phone:860-801-5040
Mailing Address - Fax:
Practice Address - Street 1:14 VINE ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1431
Practice Address - Country:US
Practice Address - Phone:860-801-5040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula