Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | SP021034 | PA |
NPI | 1285277913 |
---|---|
Provider Name | Sara Anne Lischerelli |
First Address | York, PA 17402-9001 |
Second Address | York, PA 17403-5176 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2019 |
Last Update Date | 29/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
SP021034 | (05) | PA |