Provider Demographics
NPI:1023598372
Name:LISA A. UHL, LLC
Entity type:Organization
Organization Name:LISA A. UHL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:UHL
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:410-446-5635
Mailing Address - Street 1:2 PLATEAU CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5383
Mailing Address - Country:US
Mailing Address - Phone:410-446-5635
Mailing Address - Fax:410-747-7475
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:21043-4783
Practice Address - Country:US
Practice Address - Phone:410-446-5635
Practice Address - Fax:410-747-7475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR122521261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)