Healthcare Provider Details

I. General information

NPI: 1215915368
Provider Name (Legal Business Name): LISA ANN LAMBERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2006
Last Update Date: 08/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N MAIN ST
WHITE RIVER JUNCTION VT
05009-0001
US

IV. Provider business mailing address

215 N MAIN ST
WHITE RIVER JUNCTION VT
05009-0001
US

V. Phone/Fax

Practice location:
  • Phone: 802-295-9363
  • Fax:
Mailing address:
  • Phone: 802-295-9363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD11502
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number042.0012007
License Number StateVT
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number14166
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: