Provider Demographics
NPI:1669589982
Name:STRYKER, LISA PAGE (CRNA)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:PAGE
Last Name:STRYKER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:PAGE
Other - Last Name:BRUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:3 ROMANS RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1768
Mailing Address - Country:US
Mailing Address - Phone:603-930-0643
Mailing Address - Fax:603-882-2477
Practice Address - Street 1:8 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3925
Practice Address - Country:US
Practice Address - Phone:603-889-2624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH025897-23-11367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30344185Medicaid
NHRE859501Medicare PIN
MABR NA0833Medicare ID - Type Unspecified
NHRE 8595Medicare ID - Type Unspecified