Provider Demographics
NPI:1366909434
Name:POSTON, LISA RENEE (FNP-C)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:RENEE
Last Name:POSTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8906 TWO NOTCH RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-6366
Mailing Address - Country:US
Mailing Address - Phone:032-543-6768
Mailing Address - Fax:803-254-3678
Practice Address - Street 1:1523 HERITAGE LN
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-3197
Practice Address - Country:US
Practice Address - Phone:843-731-2162
Practice Address - Fax:843-673-9996
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22578363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP6263Medicaid