Provider Demographics
NPI:1306890843
Name:PAGE, LISA C (ARNP)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:C
Last Name:PAGE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 GEORGETOWN DR
Mailing Address - Street 2:
Mailing Address - City:CENTER BARNSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03225-3321
Mailing Address - Country:US
Mailing Address - Phone:603-897-9107
Mailing Address - Fax:
Practice Address - Street 1:1 BEDFORD FARMS DR STE 2D
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6524
Practice Address - Country:US
Practice Address - Phone:603-836-9521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04257423363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9239438OtherARNP STATE LICENSE