Healthcare Provider Details

I. General information

NPI: 1649239021
Provider Name (Legal Business Name): LISA ELMORE CURTIS MS, APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 08/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5261 CARROLLTON PIKE SUITE B
WOODLAWN VA
24381-3030
US

IV. Provider business mailing address

5261 CARROLLTON PIKE SUITE B
WOODLAWN VA
24381-3030
US

V. Phone/Fax

Practice location:
  • Phone: 276-238-8876
  • Fax: 276-238-8886
Mailing address:
  • Phone: 276-238-8876
  • Fax: 276-238-8886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024165319
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: