Healthcare Provider Details

I. General information

NPI: 1508830332
Provider Name (Legal Business Name): LISA A DENZER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 04/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL RD CALLER BOX C-268
CHEROKEE NC
28719-9253
US

IV. Provider business mailing address

1 HOSPITAL RD CALLER BOX C-268
CHEROKEE NC
28719-9253
US

V. Phone/Fax

Practice location:
  • Phone: 828-497-9163
  • Fax: 828-497-1723
Mailing address:
  • Phone: 828-497-9163
  • Fax: 828-497-1723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number177873
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201495
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: