Provider Demographics
NPI:1124477542
Name:MACKEVERICAN, LISA HHELENE (CD (DONA))
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:HHELENE
Last Name:MACKEVERICAN
Suffix:
Gender:F
Credentials:CD (DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3715 LINDY DR.
Mailing Address - Street 2:
Mailing Address - City:OREFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:18069
Mailing Address - Country:US
Mailing Address - Phone:484-358-0797
Mailing Address - Fax:
Practice Address - Street 1:3715 LINDY DR.
Practice Address - Street 2:
Practice Address - City:OREFIELD
Practice Address - State:PA
Practice Address - Zip Code:18069
Practice Address - Country:US
Practice Address - Phone:484-358-0797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula