Healthcare Provider Details

I. General information

NPI: 1982033387
Provider Name (Legal Business Name): LISA DANIELS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2013
Last Update Date: 09/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

694 GOOD DR SUITE 11
LANCASTER PA
17601-2433
US

IV. Provider business mailing address

931 HARRISBURG AVENUE LGH @ F & M COLL STUDENT WELL CTR #9
LANCASTER PA
17603-2652
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-3737
  • Fax: 717-544-3739
Mailing address:
  • Phone: 717-544-9051
  • Fax: 717-735-9234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP013549
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN617079
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: