Provider Demographics
NPI:1326203910
Name:CULLIGAN, LISA A (MSN CRNP)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:A
Last Name:CULLIGAN
Suffix:
Gender:F
Credentials:MSN CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 UNION STATION PLZ
Mailing Address - Street 2:ST. LUKE'S KIDSCARE CLINIC
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1281
Mailing Address - Country:US
Mailing Address - Phone:610-954-4325
Mailing Address - Fax:610-954-4317
Practice Address - Street 1:240 UNION STATION PLZ
Practice Address - Street 2:ST. LUKE'S KIDSCARE CLINIC
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1281
Practice Address - Country:US
Practice Address - Phone:610-954-4325
Practice Address - Fax:610-954-4317
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007592363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP95211Medicare UPIN