Provider Demographics
NPI:1538100912
Name:LORD, LISA J (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:LORD
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:J
Other - Last Name:SPARCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:2592 VINING BRANCH WAY
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27523-8520
Mailing Address - Country:US
Mailing Address - Phone:919-998-9143
Mailing Address - Fax:
Practice Address - Street 1:2592 VINING BRANCH WAY
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27523-8520
Practice Address - Country:US
Practice Address - Phone:919-998-9143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered