Healthcare Provider Details

I. General information

NPI: 1235373705
Provider Name (Legal Business Name): LISA A HOHL CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 06/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30265 COMMERCE DR UNIT 206
MILLSBORO DE
19966
US

IV. Provider business mailing address

30265 COMMERCE DR UNIT 206
MILLSBORO DE
19966-3595
US

V. Phone/Fax

Practice location:
  • Phone: 302-732-8400
  • Fax: 302-934-6705
Mailing address:
  • Phone: 302-732-8400
  • Fax: 302-934-6705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0000492
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: