Individual
LISA G OBERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-4274
(704) 384-5636
Mailing address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-4274
(704) 384-5636
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
APN10992
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
071172
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052930
—
NC
05
—
NAN779
—
SC
Enumeration date
10/09/2006
Last updated
02/17/2008
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