Provider Demographics
NPI:1184819088
Name:MORERE, LISA C (APRN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:C
Last Name:MORERE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:KATHLEEN
Other - Last Name:COLOSIMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 DUKE MEDICINE CIR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-684-5301
Mailing Address - Fax:919-684-6674
Practice Address - Street 1:20 DUKE MEDICINE CIR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-684-5301
Practice Address - Fax:919-684-6674
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169504363LA2200X
SC3651363LA2200X
NH084951-23363LA2200X
NC5003375363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA32198603Medicare PIN