Healthcare Provider Details

I. General information

NPI: 1326042383
Provider Name (Legal Business Name): LISA A KAPPES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA A TURK

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 11/25/2022
Certification Date: 11/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PINE WEST PLZ STE 101
ALBANY NY
12205-5531
US

IV. Provider business mailing address

PO BOX 14890
ALBANY NY
12212-4890
US

V. Phone/Fax

Practice location:
  • Phone: 518-464-9999
  • Fax: 518-464-9650
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF331790-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: