Provider Demographics
NPI:1427093756
Name:NELMS, LISA N (DPM)
Entity type:Individual
Prefix:MISS
First Name:LISA
Middle Name:N
Last Name:NELMS
Suffix:
Gender:F
Credentials:DPM
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Mailing Address - Street 1:1031 MIRAMONTE DR
Mailing Address - Street 2:APT 6
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93109-1327
Mailing Address - Country:US
Mailing Address - Phone:805-733-4869
Mailing Address - Fax:805-733-1213
Practice Address - Street 1:2030 VIBORG RD STE 104
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-3224
Practice Address - Country:US
Practice Address - Phone:805-686-3961
Practice Address - Fax:805-733-1213
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE4325213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA485511Medicare UPIN
CAE4325Medicare UPIN