MRS. LISA LALLIER BLACKWELDER FNP NPI 1396990164

NPI Information

NPI: 1396990164
Provider Name: MRS. LISA LALLIER BLACKWELDER, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
7610 N UNION BLVD STE 140
COLORADO SPRINGS, CO
ZIP 80920
Phone: (719) 550-1172
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MRS. Lisa Lallier Blackwelder, FNP is a family nurse practitioner in Colorado Springs, CO with 22 years of experience. MRS. Lisa Lallier Blackwelder, FNP NPI is 1396990164. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7610 N UNION BLVD STE 140
COLORADO SPRINGS, CO
ZIP 80920-894
Phone: (719) 550-1172
Fax: (719) 591-2864

The NPI 1396990164 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/20/2008 and was last updated on 1/10/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	579092	TEXAS	No
2	363LF0000X	Nurse Practitioner	Family	APN.0992320-NP	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	75-2616977-002	OTHER	TEXAS	TRICARE
2	9000191726	MEDICAID	COLORADO
3	75-2616977-001	OTHER	TEXAS	TRICARE
4	75-2616977-028	OTHER	TEXAS	TRICARE
5	7508181567022	OTHER	TEXAS	TRICARE
6	070853903	MEDICAID	TEXAS
7	579092	OTHER	TEXAS	FAMILY NURSE PRACTITIONER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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