Healthcare Provider Details

I. General information

NPI: 1932536422
Provider Name (Legal Business Name): LISA B. STEIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 BLAIR MILL RD
HORSHAM PA
19044-2223
US

IV. Provider business mailing address

108 S THOMAS AVE
EDWARDSVILLE PA
18704-4419
US

V. Phone/Fax

Practice location:
  • Phone: 570-814-3259
  • Fax: 570-344-2238
Mailing address:
  • Phone: 570-814-3259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP013179
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN529243L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: