Provider Demographics
NPI:1144001058
Name:SIFFORD, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SIFFORD
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 1:9700 RESEARCH DR STE 153
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-8587
Mailing Address - Country:US
Mailing Address - Phone:980-237-1364
Mailing Address - Fax:800-531-0918
Practice Address - Street 1:9700 RESEARCH DR STE 153
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8587
Practice Address - Country:US
Practice Address - Phone:980-237-1364
Practice Address - Fax:800-531-0918
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)