Provider Demographics
NPI:1619860178
Name:PACE, LISA NICOLE (CD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:NICOLE
Last Name:PACE
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2229 HIGHWAY 183
Mailing Address - Street 2:
Mailing Address - City:RAYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71269-7044
Mailing Address - Country:US
Mailing Address - Phone:318-953-9443
Mailing Address - Fax:
Practice Address - Street 1:2229 HIGHWAY 183
Practice Address - Street 2:
Practice Address - City:RAYVILLE
Practice Address - State:LA
Practice Address - Zip Code:71269-7044
Practice Address - Country:US
Practice Address - Phone:318-953-9443
Practice Address - Fax:318-953-9443
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula