Provider Demographics
NPI:1396799169
Name:WILLIAMS, LISA M (RN APRN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 PINE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-4819
Mailing Address - Country:US
Mailing Address - Phone:603-785-7526
Mailing Address - Fax:603-580-5953
Practice Address - Street 1:10 CHESTNUT DR UNIT M
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-5555
Practice Address - Country:US
Practice Address - Phone:603-785-7526
Practice Address - Fax:603-580-5953
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHRN04168721163WP0808X
NHARNP0416872308363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q50775Medicare UPIN
NP5113Medicare ID - Type Unspecified