Provider Demographics
NPI:1407682560
Name:STROUPE-KEPHART, LISA SHAWN (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:SHAWN
Last Name:STROUPE-KEPHART
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:561 JUDY LN
Mailing Address - Street 2:
Mailing Address - City:STANLEY
Mailing Address - State:VA
Mailing Address - Zip Code:22851-4006
Mailing Address - Country:US
Mailing Address - Phone:540-476-3972
Mailing Address - Fax:
Practice Address - Street 1:2006 HEALTH CAMPUS DR FL 3
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:22801-8679
Practice Address - Country:US
Practice Address - Phone:540-689-7400
Practice Address - Fax:844-220-9492
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024191208363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care