Provider Demographics
NPI:1225050933
Name:VASILE, LISA MARIE (NP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:VASILE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:85 MAIN ST
Mailing Address - Street 2:4 BETTER HEALTH, INC
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748
Mailing Address - Country:US
Mailing Address - Phone:508-625-1807
Mailing Address - Fax:508-625-1162
Practice Address - Street 1:85 MAIN ST
Practice Address - Street 2:4 BETTER HEALTH INC
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748
Practice Address - Country:US
Practice Address - Phone:508-625-1807
Practice Address - Fax:508-625-1162
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA195359363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAVX2225OtherMEDICARE PTAN
MAVX2225OtherMEDICARE PTAN