Provider Demographics
NPI:1174861223
Name:KIMSEY, LISA PIERCE (MS)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:PIERCE
Last Name:KIMSEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PARK VISTA DR UNIT 2090
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-3030
Mailing Address - Country:US
Mailing Address - Phone:702-526-3410
Mailing Address - Fax:
Practice Address - Street 1:100 PARK VISTA DR UNIT 2090
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89138-3030
Practice Address - Country:US
Practice Address - Phone:702-526-3410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator