Individual
LISA STAAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2 LEE AVE, GEORGETOWN, DE 19947-2149
(302) 856-4092
Mailing address
541 CHESTNUT HILL RD, FOREST HILL, MD 21050-1720
(443) 528-4639
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R085703
MD
363LP2300X
Primary Care Nurse Practitioner
Primary
LG-0011818
DE
Other
Enumeration date
03/22/2021
Last updated
04/11/2023
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