Provider Demographics
NPI:1487685608
Name:DEWEES, LISA LR (CRNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:LR
Last Name:DEWEES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:RIDER
Other - Last Name:DEWEES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-2334
Mailing Address - Fax:717-851-3498
Practice Address - Street 1:605 S GEORGE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3160
Practice Address - Country:US
Practice Address - Phone:717-851-2334
Practice Address - Fax:717-851-3498
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP004116B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1529533OtherGATEWAY-YH
PA03273801OtherCAPITAL BLUE CROSS-YH
PA20021029OtherAMERIHEALTH MERCY-YH
MD617075OtherCAREFIRST MD BCBS
PA500023783OtherRAILROAD MEDICARE
PA105394OtherJOHNS HOPKINS
PA20021029OtherAMERIHEALTH MERCY-YH
PA050639EZ3Medicare PIN