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Individual

LISA A WUNDERLICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
100 HITCHCOCK WAY, MANCHESTER, NH 03104-4125
(603) 695-2500
Mailing address
250 PLEASANT ST, CONCORD, NH 03301-7559
(603) 789-9103
(603) 227-7832

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
040076-23
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30343405
NH
Enumeration date
11/20/2006
Last updated
07/18/2024
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