Healthcare Provider Details

I. General information

NPI: 1609488337
Provider Name (Legal Business Name): LISA ANN HERMANSKY MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2020
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 E PULASKI HWY FL 3
ELKTON MD
21921-6457
US

IV. Provider business mailing address

291 CARTER DR STE B
MIDDLETOWN DE
19709-5845
US

V. Phone/Fax

Practice location:
  • Phone: 844-365-2202
  • Fax: 844-558-1878
Mailing address:
  • Phone: 844-365-2202
  • Fax: 844-558-1878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAC007761
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0011453
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberLG-0011453
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAC007761
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ01045200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: