Basic Information
Provider Information
NPI: 1003139593
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WESCOTT
FirstName: LISA
MiddleName: ANNE
NamePrefix: MS.
NameSuffix:  
Credential: MSN, CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HILL
OtherFirstName: LISA
OtherMiddleName: ANNE
OtherNamePrefix: MRS.
OtherNameSuffix:  
OtherCredential: MSN, CRNP
OtherLastNameType: 1
Mailing Information
Address1: 131 HARVARD DR
Address2:  
City: TRAPPE
State: PA
PostalCode: 194261962
CountryCode: US
TelephoneNumber: 6105062801
FaxNumber:  
Practice Location
Address1: 131 HARVARD DR
Address2:  
City: TRAPPE
State: PA
PostalCode: 194261962
CountryCode: US
TelephoneNumber: 6105062801
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/11/2010
LastUpdateDate: 01/03/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XSP010670PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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