Provider Demographics
NPI:1750949947
Name:HARPER, LISA NICHOLA (NP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:NICHOLA
Last Name:HARPER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2713 FOREST HILLS RD SW BLDG 2
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4432
Mailing Address - Country:US
Mailing Address - Phone:252-246-5990
Mailing Address - Fax:252-206-4987
Practice Address - Street 1:498 OAK RD BLDG 3
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-3006
Practice Address - Country:US
Practice Address - Phone:352-687-5165
Practice Address - Fax:352-687-5314
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-03
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLF02181097363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty