MS. TERESA LYNN LISBURG (NPI# 1770833675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770833675 |
| Entity Type | Individual |
| Full Name | MS. TERESA LYNN LISBURG |
| Credential | OPTICIAN |
| Practice Address |
1404 33rd St Sw Suite 1 Fargo ND 58103-3482 |
| Mailing Address |
1404 33rd Street Southwest Suite 1 Fargo ND 58103 |
| Practice Telephone | 7012120758 |
| Mailing Telephone | 7012120758 |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2012-09-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| Street Address |
1404 33RD ST SW SUITE 1 |
| City | FARGO |
| State | ND |
| Zip Code | 58103-3482 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528382900 | Blue Eye Inc | Technician/Technologist | 100 So 4th St, Ste 108, Fargo, ND 58103-1929 | 2010-03-15 |
| 1649343930 | Douglas John Stavenger | Technician/Technologist | 1547 So University Dr, Fargo, ND 58103 | 2006-11-16 |
| 1114007960 | Sam's Club Optical | Technician/Technologist | 4831 13th Ave S, Fargo, ND 58103-7206 | 2006-10-16 |
| 1528175429 | 3-d Optical Inc | Technician/Technologist | 3402 13th Ave S, Suite E, Fargo, ND 58103-6324 | 2006-08-24 |
| 1033606728 | Aspire Optical Co., LLC | Technician/Technologist | 3265 45th St S Ste 104, Fargo, ND 58104-7930 | 2018-04-18 |
| 1699847293 | Midwest Vision Centers Inc | Technician/Technologist | 3051 25th St S, Suite K2, Fargo, ND 58103-6102 | 2006-11-15 |
| 1023198868 | Wal-mart Stores, Inc. | Technician/Technologist | 4731 13th Ave S, Fargo, ND 58103-7205 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104318575 | Kelsie Ann Butts | Technician/Technologist | 1487 E Lasalle Dr, Bismarck, ND 58503-5653 | 2018-06-01 |
| 1508283730 | Wal-mart Stores, Inc. | Technician/Technologist | 1424 Highway 2 E, Devils Lake, ND 58301-4000 | 2014-03-26 |
| 1508291626 | Lighthouse Optical Inc. | Technician/Technologist | 317 Cooper Ave, Grafton, ND 58237 | 2013-09-09 |
| 1235578907 | Wal-mart Stores, Inc | Technician/Technologist | 1000 Old Red Trl Ne, Mandan, ND 58554-1591 | 2013-06-17 |
| 1437451440 | David Pederson | Technician/Technologist | 4551 S Washington St Ste H, Grand Forks, ND 58201-3495 | 2010-11-23 |
| 1619169174 | John Bitz | Technician/Technologist | 210 W Front Ave, Bismarck, ND 58504-5503 | 2007-08-17 |
| 1104906940 | Wal-mart Stores, Inc. | Technician/Technologist | 2003 3rd Ave W, Dickinson, ND 58601-3024 | 2006-10-16 |
| 1316037591 | Sam's Club Optical | Technician/Technologist | 2501 32nd Ave S, Grand Forks, ND 58201-6542 | 2006-10-16 |
| 1922188762 | Wal-mart Stores, Inc. | Technician/Technologist | 2551 32nd Ave S, Grand Forks, ND 58201-6542 | 2006-10-16 |
| 1205916046 | Wal-mart Stores, Inc. | Technician/Technologist | 1901 22nd Ave Sw, Minot, ND 58701-6988 | 2006-10-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.