Provider Demographics
NPI:1881476521
Name:CAPITANI, LISA P (RN)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:P
Last Name:CAPITANI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 STUART DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-2768
Mailing Address - Country:US
Mailing Address - Phone:860-977-0259
Mailing Address - Fax:
Practice Address - Street 1:5 STUART DR
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-2768
Practice Address - Country:US
Practice Address - Phone:860-977-0259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY857637-01163WG0000X
CT76242163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice