Provider Demographics
NPI:1063223154
Name:MARIA, LISA ANN (RCP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:MARIA
Suffix:
Gender:
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 FLAGSTONE LN
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-6509
Mailing Address - Country:US
Mailing Address - Phone:770-598-2800
Mailing Address - Fax:
Practice Address - Street 1:1660 FLAGSTONE LN
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-6509
Practice Address - Country:US
Practice Address - Phone:770-598-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral Care
No2278E1000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedEducational