Healthcare Provider Details

I. General information

NPI: 1497478317
Provider Name (Legal Business Name): CAMEO LYSSA HIPPERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 NORTH DUKE STREET
LANCASTER PA
17602-2250
US

IV. Provider business mailing address

555 NORTH DUKE STREET
LANCASTER PA
17602-2250
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-4676
  • Fax: 717-544-7157
Mailing address:
  • Phone: 717-544-4676
  • Fax: 717-544-7157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN631204
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: