Provider Demographics
NPI:1447830195
Name:TAMPRATEEP, LISA CHENGSHA ZHU
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:CHENGSHA ZHU
Last Name:TAMPRATEEP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10440 LITTLE PATUXENT PKWY STE 800
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3569
Mailing Address - Country:US
Mailing Address - Phone:314-374-9502
Mailing Address - Fax:
Practice Address - Street 1:913 KIEFER TRAILS DR
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63021-6078
Practice Address - Country:US
Practice Address - Phone:314-374-9502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO514464163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse