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General NPI Number Information
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NPI Number | 1407307929
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Entity Type | Individual
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Provider Name | LISA STERN ARNP
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Gender | Female
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Dates
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Enumeration Date | 10/19/2016
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Last Update Date | 08/01/2022
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Provider Practice Location Address
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Address Line | 2001 KINGSLEY AVE
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City | ORANGE PARK
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State | FL
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Zip | 32073-5148
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Country | US
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Telephone | 904-639-8145
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 KINGSLEY AVE
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City | ORANGE PARK
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State | FL
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Zip | 32073-5148
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Country | US
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Telephone | 904-639-8500
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Fax | 904-276-8574
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP2498772
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | ARNP2498772
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License Number State | FL
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