MEDICARE: LISA STRASSNER HUTCHCRAFT NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	NP 990242	CO
2	363LF0000X	Family Nurse Practitioner	RN203469	GA

General Provider Information

NPI Number	:	1710233929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA STRASSNER HUTCHCRAFT NP-C

Provider Business Mailing Address
First Line	:	3190 E LAS VEGAS ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-8002
Country	:	US
Telephone Number	:	719-390-2736
Fax Number	:	719-390-2739

Provider Business Practice Location Address
First Line	:	3190 E LAS VEGAS ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-8002
Country	:	US
Telephone Number	:	719-390-2736
Fax Number	:	719-390-2739

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2012
Last Update Date	:	07/25/2012

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