Provider Demographics
NPI:1336143254
Name:ALBERT, LISA K (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:K
Last Name:ALBERT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 N BETHLEHEM PIKE
Mailing Address - Street 2:STE 101
Mailing Address - City:LOWER GWYNEDD
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2655
Mailing Address - Country:US
Mailing Address - Phone:215-540-4411
Mailing Address - Fax:215-540-4415
Practice Address - Street 1:714 N BETHLEHEM PIKE
Practice Address - Street 2:STE 101
Practice Address - City:LOWER GWYNEDD
Practice Address - State:PA
Practice Address - Zip Code:19002-2655
Practice Address - Country:US
Practice Address - Phone:215-540-4411
Practice Address - Fax:215-540-4415
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP006911C207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP68859Medicare UPIN
PA063076QW5Medicare ID - Type Unspecified