Provider Demographics
NPI:1114997103
Name:BILLITER, LISA ANN (CNM)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:BILLITER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:A
Other - Last Name:HINKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:694 GOOD DR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2433
Mailing Address - Country:US
Mailing Address - Phone:717-397-8177
Mailing Address - Fax:717-397-2426
Practice Address - Street 1:694 GOOD DR
Practice Address - Street 2:SUITE 112
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2433
Practice Address - Country:US
Practice Address - Phone:717-397-8177
Practice Address - Fax:717-397-2426
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW010049176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001971946Medicaid
PA073304ESCMedicare ID - Type Unspecified
PA001971946Medicaid