Provider Demographics
NPI:1023634797
Name:SEAWRIGHT, LISA A (CNA)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:SEAWRIGHT
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 BILL FRANCE BLVD UNIT 9831
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32120-7037
Mailing Address - Country:US
Mailing Address - Phone:386-262-8337
Mailing Address - Fax:
Practice Address - Street 1:1135 RAIFORD AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-3403
Practice Address - Country:US
Practice Address - Phone:386-262-8337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL45623376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide