Provider Demographics
NPI:1831388123
Name:CAPUANO-OLSON, LISA LYNN (FNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:LYNN
Last Name:CAPUANO-OLSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 GREENHILL AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1844
Mailing Address - Country:US
Mailing Address - Phone:302-429-5870
Mailing Address - Fax:302-429-9284
Practice Address - Street 1:213 GREENHILL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-1844
Practice Address - Country:US
Practice Address - Phone:302-429-5870
Practice Address - Fax:302-429-9284
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEAPN-0001422363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily