Provider Demographics
NPI:1013289172
Name:MEEDER, LISA BETH (CRNA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:BETH
Last Name:MEEDER
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:PO BOX 350
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-0350
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:325 CENTRAL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3265
Practice Address - Country:US
Practice Address - Phone:610-644-6755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN530475L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered