Individual
LISA C RADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A-NP
Contact information
Practice address
104 SELMA DR, WINCHESTER, VA 22601
(540) 678-2800
(540) 678-2859
Mailing address
104 SELMA DR, WINCHESTER, VA 22601
(540) 678-2800
(540) 678-2859
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NP0024166267
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
384801
ANTHEM
VA
Enumeration date
04/20/2006
Last updated
02/15/2017
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