Provider Demographics
NPI:1275320756
Name:ZALIAUSKAS, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ZALIAUSKAS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SUNDEW CT
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2579
Mailing Address - Country:US
Mailing Address - Phone:510-371-2087
Mailing Address - Fax:
Practice Address - Street 1:1 SUNDEW CT
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-2579
Practice Address - Country:US
Practice Address - Phone:510-371-2087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC220902163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty