Provider Demographics
NPI:1831628528
Name:CALABRESE, LISA (RN)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:LASKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:621 AGNES AVE
Mailing Address - Street 2:
Mailing Address - City:BRIELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08730-1801
Mailing Address - Country:US
Mailing Address - Phone:732-208-2166
Mailing Address - Fax:
Practice Address - Street 1:3715 N BUSINESS DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5204
Practice Address - Country:US
Practice Address - Phone:609-216-2657
Practice Address - Fax:479-582-0778
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR06081600163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse