Healthcare Provider Details

I. General information

NPI: 1114997103
Provider Name (Legal Business Name): LISA ANN BILLITER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA A HINKLE

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 11/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

694 GOOD DR SUITE 112
LANCASTER PA
17601-2433
US

IV. Provider business mailing address

694 GOOD DR SUITE 112
LANCASTER PA
17601-2433
US

V. Phone/Fax

Practice location:
  • Phone: 717-397-8177
  • Fax: 717-397-2426
Mailing address:
  • Phone: 717-397-8177
  • Fax: 717-397-2426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW010049
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: