Healthcare Provider Details

I. General information

NPI: 1164676607
Provider Name (Legal Business Name): LISA KAREN MUCHLER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA KAREN WALSH NP-C

II. Dates (important events)

Enumeration Date: 11/11/2008
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 N MAIN ST
PITTSTON PA
18640-1916
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-9800
US

V. Phone/Fax

Practice location:
  • Phone: 570-602-5610
  • Fax: 570-602-5611
Mailing address:
  • Phone: 570-602-5610
  • Fax: 570-602-5611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP010022
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNPPA065685
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN512613L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: