Dedomenico, Lisa M.
Dedomenico, Lisa M. is an individual health care provider with primary practice located at 190 Welles St , Kingston PA 18704-4968. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Dedomenico, Lisa M. can be contacted via phone (570) 714-1099.Contact Information
Primary practice address
190 Welles St
Kingston PA 18704-4968
Phone: (570) 714-1099
Fax: (570) 714-1116
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology | 363LX0001X | TP001029G | Pennsylvania |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | TP001029G | Pennsylvania |
Profile Details
NPI number | 1184657751 |
---|---|
LBN Legal business name | Dedomenico, Lisa M. |
Credentials | CRNP, MSN |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 8th, 2006 |
Last updated | Jul 30th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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