Provider Demographics
NPI:1578034880
Name:BARKLEY, LISA PITONYAK (CRNP-C)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:PITONYAK
Last Name:BARKLEY
Suffix:
Gender:F
Credentials:CRNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-1112
Mailing Address - Country:US
Mailing Address - Phone:717-387-2983
Mailing Address - Fax:
Practice Address - Street 1:6 BELLA VISTA DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-1879
Practice Address - Country:US
Practice Address - Phone:717-516-1290
Practice Address - Fax:877-991-9125
Is Sole Proprietor?:No
Enumeration Date:2018-12-12
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP019439363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner