Provider Demographics
NPI:1962008433
Name:SIKORSKI, LISA (APRN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SIKORSKI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 BARCARMIL WAY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-0903
Mailing Address - Country:US
Mailing Address - Phone:239-265-3391
Mailing Address - Fax:239-425-3214
Practice Address - Street 1:235 BAY MEADOWS DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-8302
Practice Address - Country:US
Practice Address - Phone:239-572-4768
Practice Address - Fax:239-489-1927
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109003700Medicaid