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Individual

LISA CLAIRE LOUGHERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1140 ROUTE 72 W, MANAHAWKIN, NJ 08050-2412
(609) 597-6011
Mailing address
PO BOX 34672, NEWARK, NJ 07189-0001
(201) 804-2800

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26NR10190000
NJ
367500000X
Certified Registered Nurse Anesthetist
RN227018L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
50077111
CAPITAL BLUE CROSS, KEYSTONE CENTRAL, SENIOR BLUE
PA
Enumeration date
06/20/2005
Last updated
05/12/2010
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