Provider Demographics
NPI:1831534627
Name:SEIBERT, LISA
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:SEIBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:PRESCOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DVM
Mailing Address - Street 1:1210 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-2609
Mailing Address - Country:US
Mailing Address - Phone:502-348-2525
Mailing Address - Fax:502-348-2533
Practice Address - Street 1:1210 N 3RD ST
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-2609
Practice Address - Country:US
Practice Address - Phone:502-348-2525
Practice Address - Fax:502-348-2533
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYNS 2394174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian