Moore, Lisa M

Moore, Lisa M is an individual health care provider with primary practice located at 690 Minot Ave Ste 1 , Auburn ME 04210-3922. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Moore, Lisa M can be contacted via phone (207) 783-1328.

Contact Information

Primary practice address
690 Minot Ave Ste 1 Auburn ME 04210-3922
Phone: (207) 783-1328
Fax: (207) 786-4332
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 9108417 Florida
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 800 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA1497 Maine

Profile Details

NPI number 1659456630
LBN Legal business name Moore, Lisa M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2006
Last updated Nov 6th, 2020 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1659456630 NPPES
Maine MEDICAID 1659456630

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