Provider Demographics
NPI:1578821799
Name:HIGHTOWER, LISA R (RN)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:R
Last Name:HIGHTOWER
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 1:530 STANLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-7714
Mailing Address - Country:US
Mailing Address - Phone:718-498-6680
Mailing Address - Fax:718-927-3554
Practice Address - Street 1:530 STANLEY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-7714
Practice Address - Country:US
Practice Address - Phone:718-498-6680
Practice Address - Fax:718-927-3554
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4124231163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool