Provider Demographics
NPI:1285370163
Name:ELIASSAINT, LISA E (RN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:E
Last Name:ELIASSAINT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6125 SPRING LAKE TER
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34951-3106
Mailing Address - Country:US
Mailing Address - Phone:772-207-0862
Mailing Address - Fax:
Practice Address - Street 1:6125 SPRING LAKE TER
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34951-3106
Practice Address - Country:US
Practice Address - Phone:772-361-5052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9386933163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy