Individual
LISA MARIE KMIECIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
87 W PINE ST., SHEPPTON, PA 18248-0300
(570) 384-1070
Mailing address
87 W PINE ST., PO BOX 300, SHEPPTON, PA 18248-0300
(570) 384-1070
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN256867L
PA
Other
Enumeration date
08/21/2007
Last updated
08/21/2007
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