Provider Demographics
NPI:1356733067
Name:KUCHTEY, LISA A (CRNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:KUCHTEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:A
Other - Last Name:CASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:4000 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1017
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4000 LINGLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1017
Practice Address - Country:US
Practice Address - Phone:717-231-8508
Practice Address - Fax:717-231-8535
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP014375363LA2200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health