Provider Demographics
NPI:1497411490
Name:ZIEGLER, LISA (FDN-P)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:FDN-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1016
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34284-1016
Mailing Address - Country:US
Mailing Address - Phone:941-544-7927
Mailing Address - Fax:
Practice Address - Street 1:301 PONCE DE LEON AVE
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2335
Practice Address - Country:US
Practice Address - Phone:941-544-7927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-14
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date: