Individual
LISA A MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
(603) 650-8630
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
030288-23
NH
363LF0000X
Family Nurse Practitioner
101.0128895
VT
Other
Enumeration date
05/05/2017
Last updated
04/24/2019
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