Provider Demographics
NPI:1164676607
Name:MUCHLER, LISA KAREN (APRN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:KAREN
Last Name:MUCHLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:KAREN
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:8706 W HILLSBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3705
Mailing Address - Country:US
Mailing Address - Phone:813-915-5459
Mailing Address - Fax:813-415-2742
Practice Address - Street 1:8706 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3705
Practice Address - Country:US
Practice Address - Phone:813-915-5459
Practice Address - Fax:813-415-2742
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010022363LF0000X
FLARNP9289996363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily