Provider Demographics
NPI:1760588347
Name:GROFT, LISA ANN URIE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANN URIE
Last Name:GROFT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 5 BOX 513G
Mailing Address - Street 2:1159 BAIR HILL RD
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-8929
Mailing Address - Country:US
Mailing Address - Phone:724-423-2036
Mailing Address - Fax:
Practice Address - Street 1:532 W PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2239
Practice Address - Country:US
Practice Address - Phone:724-832-4217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN262223L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered