Provider Demographics
NPI:1710867783
Name:LIEWA, LISA LOUISE (RN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:LOUISE
Last Name:LIEWA
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 1:6528 BUTTERFLY SKY ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-1320
Mailing Address - Country:US
Mailing Address - Phone:310-902-1671
Mailing Address - Fax:
Practice Address - Street 1:6528 BUTTERFLY SKY ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-1320
Practice Address - Country:US
Practice Address - Phone:310-902-1671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN58426163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse