Provider Demographics
NPI:1346210937
Name:NURRE, LISA D (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:D
Last Name:NURRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 392
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0392
Mailing Address - Country:US
Mailing Address - Phone:800-467-3381
Mailing Address - Fax:828-586-8209
Practice Address - Street 1:80 PEACHTREE RD STE 106
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3180
Practice Address - Country:US
Practice Address - Phone:828-232-5222
Practice Address - Fax:828-258-3003
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9501031207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89128UGMedicaid
G42446Medicare UPIN
NC2344796Medicare PIN