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NPI Code Detail

MEDICARE: LISA MARIE GENOVESE ARNP

MEDICARE: LISA MARIE GENOVESE ARNP
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
1363LF0000XFamily Nurse PractitionerARNP9233666FL
2363LF0000XFamily Nurse Practitioner320700NC
3363L00000XNurse Practitioner320700NC

General Provider Information

NPI Number : 1730456369
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE GENOVESE ARNP
Provider Business Mailing Address
First Line : 1021 DARRINGTON DR STE 101
Second Line :
City : CARY
State : NC
Zip : 27513-8158
Country : US
Telephone Number : 198-523-9999
Fax Number : 919-378-9114
Provider Business Practice Location Address
First Line : 804 ENGLISH RD STE 100
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-6027
Country : US
Telephone Number : 252-443-3133
Fax Number : 252-443-0847
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2011
Last Update Date : 01/25/2022

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