Provider Demographics
NPI:1740222900
Name:CROUGH, LISA (RN ARNP MSN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:CROUGH
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Gender:F
Credentials:RN ARNP MSN
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Mailing Address - Street 1:20805 W 151ST STREET
Mailing Address - Street 2:BUILDING 2 SUITE 400
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5353
Mailing Address - Country:US
Mailing Address - Phone:913-780-4900
Mailing Address - Fax:913-780-0949
Practice Address - Street 1:20805 W 151ST STREET
Practice Address - Street 2:BUILDING 2 SUITE 400
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5353
Practice Address - Country:US
Practice Address - Phone:913-780-4900
Practice Address - Fax:913-780-0949
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-07-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KSARNP45648363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner