Individual
LISA VERBOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1245 S CEDAR CREST BLVD STE 301, ALLENTOWN, PA 18103-6258
(610) 402-8896
(610) 402-9029
Mailing address
1245 S CEDAR CREST BLVD STE 301, ALLENTOWN, PA 18103-6258
(610) 402-8896
(610) 402-9029
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
91022
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027813210001
—
PA
01
—
1053663773
GEISINGER
PA
01
—
12447550
CAQH
PA
01
—
1613617
GATEWAY
PA
01
—
2745894
FIRST PRIORITY
PA
01
—
3888599000
IND. BLUE CROSS
PA
01
—
50111778
CAPITAL ADVANTAGE
PA
01
—
9177918
AETNA
PA
Enumeration date
10/04/2012
Last updated
04/07/2015
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