Provider Demographics
NPI:1912221672
Name:PAQUET, LISA ELAINE (LPN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ELAINE
Last Name:PAQUET
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 HERTEL AVE
Mailing Address - Street 2:APT 206
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-2548
Mailing Address - Country:US
Mailing Address - Phone:716-783-7394
Mailing Address - Fax:
Practice Address - Street 1:346 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-1804
Practice Address - Country:US
Practice Address - Phone:716-856-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196632164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse