Provider Demographics
NPI:1811603301
Name:CANNATELLI, LISA A (LPN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:CANNATELLI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ANN
Other - Last Name:ABLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:415 LEESBURG RD
Mailing Address - Street 2:
Mailing Address - City:TELFORD
Mailing Address - State:TN
Mailing Address - Zip Code:37690-2327
Mailing Address - Country:US
Mailing Address - Phone:302-650-7037
Mailing Address - Fax:
Practice Address - Street 1:415 LEESBURG RD
Practice Address - Street 2:
Practice Address - City:TELFORD
Practice Address - State:TN
Practice Address - Zip Code:37690-2327
Practice Address - Country:US
Practice Address - Phone:302-650-7037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN91597164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse