Provider Demographics
NPI:1285055228
Name:BECK, LISA LEE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:LEE
Last Name:BECK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:LEE
Other - Last Name:SNEGOSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 5418
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27204-5418
Mailing Address - Country:US
Mailing Address - Phone:336-625-2333
Mailing Address - Fax:336-625-5511
Practice Address - Street 1:700 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5304
Practice Address - Country:US
Practice Address - Phone:336-625-0305
Practice Address - Fax:336-625-9941
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-04643363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0010-04643OtherNORTH CAROLINA MEDICAL BOARD