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General NPI Number Information
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NPI Number | 1891070405
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Entity Type | Individual
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Provider Name | LISA A TOMKO CRNP
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Gender | Female
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Dates
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Enumeration Date | 10/14/2011
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 22 ST PAUL DR STE 204
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-1036
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Country | US
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Telephone | 172-176-9447
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Fax | 717-217-6955
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Provider Business Mailing Address
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Address Line | 785 5TH AVE STE 3
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-4232
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Country | US
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Telephone | 717-709-6553
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Fax | 717-709-6529
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SP011661
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License Number State | PA
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