Provider Demographics
NPI:1982941514
Name:NOWICKI, LISA (DVM)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:NOWICKI
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6543 ST VRAIN RANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:FIRESTONE
Mailing Address - State:CO
Mailing Address - Zip Code:80504-9728
Mailing Address - Country:US
Mailing Address - Phone:413-329-5662
Mailing Address - Fax:
Practice Address - Street 1:17701 COTTONWOOD DR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3939
Practice Address - Country:US
Practice Address - Phone:720-842-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0008659174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian