Individual
LISA MARIE M PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.R.N.A.
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-2415
Mailing address
425 LEWIS HARGETT CIR, LEXINGTON, KY 40503-3590
(859) 268-1030
(859) 269-4120
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
256932
MA
163W00000X
Registered Nurse
607721
NY
163W00000X
Registered Nurse
636631
CA
163W00000X
Registered Nurse
88045
VT
367500000X
Certified Registered Nurse Anesthetist
3010203
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
88148
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95000710
CRNA LICENSE
CA
Enumeration date
10/20/2011
Last updated
09/18/2018
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