Basic Information
Provider Information
NPI: 1003135856
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PRESNELL
FirstName: LISA
MiddleName: AUSTIN
NamePrefix: MRS.
NameSuffix:  
Credential: RNC-OB
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 991 W HUDSON BLVD
Address2:  
City: GASTONIA
State: NC
PostalCode: 280526430
CountryCode: US
TelephoneNumber: 7048535000
FaxNumber: 7048535188
Practice Location
Address1: 991 W HUDSON BLVD
Address2:  
City: GASTONIA
State: NC
PostalCode: 280526430
CountryCode: US
TelephoneNumber: 7048535000
FaxNumber: 7048535188
Other Information
ProviderEnumerationDate: 05/19/2010
LastUpdateDate: 05/19/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WX0002X133826NCY Nursing Service ProvidersRegistered NurseObstetric, High-Risk

No ID Information.


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