Provider Demographics
NPI:1013140623
Name:UHL, LISA ANN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANN
Last Name:UHL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:ANN
Other - Last Name:MOTTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 PLATEAU CT
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5383
Mailing Address - Country:US
Mailing Address - Phone:410-446-5635
Mailing Address - Fax:
Practice Address - Street 1:3691 PARK AVE STE 9
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043
Practice Address - Country:US
Practice Address - Phone:301-279-2779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-29
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR122521363LP0808X
MDR12251363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health