Provider Demographics
NPI:1316731169
Name:DUFFY, LISA B (BSN, RN, CLC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:B
Last Name:DUFFY
Suffix:
Gender:
Credentials:BSN, RN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 BARATARIA BLVD
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-1839
Mailing Address - Country:US
Mailing Address - Phone:504-368-7337
Mailing Address - Fax:504-367-7376
Practice Address - Street 1:829 BARATARIA BLVD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-1839
Practice Address - Country:US
Practice Address - Phone:504-368-7337
Practice Address - Fax:504-368-7376
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA361392174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN