Provider Demographics
NPI:1245674779
Name:VEAL, LISA FAYE (LPN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:FAYE
Last Name:VEAL
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 1:2426 REESER LN
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-5633
Mailing Address - Country:US
Mailing Address - Phone:931-787-5404
Mailing Address - Fax:
Practice Address - Street 1:2426 REESER LN
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-5633
Practice Address - Country:US
Practice Address - Phone:931-787-5404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41540164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse