Provider Demographics
NPI:1801169925
Name:PAINE, LISA STERN (ARNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:STERN
Last Name:PAINE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:CHRISTINE
Other - Last Name:STERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:11175 COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-5615
Mailing Address - Country:US
Mailing Address - Phone:352-686-8888
Mailing Address - Fax:352-684-6888
Practice Address - Street 1:11175 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609
Practice Address - Country:US
Practice Address - Phone:352-686-8888
Practice Address - Fax:352-684-6888
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2020-09-14
Deactivation Date:2019-07-24
Deactivation Code:
Reactivation Date:2019-08-01
Provider Licenses
StateLicense IDTaxonomies
FLARNP9171088363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004539100Medicaid
FLY0AZ5OtherBCBS