Provider Demographics
NPI:1295001931
Name:REECE, LISA MARIE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:REECE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:DOCHERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:455 WOODVIEW RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390-9314
Mailing Address - Country:US
Mailing Address - Phone:610-345-1900
Mailing Address - Fax:
Practice Address - Street 1:455 WOODVIEW RD STE 100
Practice Address - Street 2:
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-9314
Practice Address - Country:US
Practice Address - Phone:610-345-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR20754363LF0000X
PASP012023363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily