Provider Demographics
NPI:1386425346
Name:ARMSTRONG, LISA GAIL
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:GAIL
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 CONESTOGA PKWY
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-6666
Mailing Address - Country:US
Mailing Address - Phone:502-281-5007
Mailing Address - Fax:502-921-9052
Practice Address - Street 1:545 CONESTOGA PKWY
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-6666
Practice Address - Country:US
Practice Address - Phone:502-281-5007
Practice Address - Fax:502-921-9052
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY287956156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician