Individual
DR. LISA ANNE MADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(901) 667-7000
Mailing address
264 ALEXANDRA DR UNIT 15, MOUNT PLEASANT, SC 29464-2841
(262) 914-4710
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
165596
NC
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/03/2020
Last updated
03/17/2021
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