Provider Demographics
NPI:1144453135
Name:WITHROW, LISA CHRISTINE (APRN, NP-C)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:CHRISTINE
Last Name:WITHROW
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:CHRISTINE
Other - Last Name:LEBLANC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, NP-C
Mailing Address - Street 1:116 S RIVER RD UNIT D-2
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6734
Mailing Address - Country:US
Mailing Address - Phone:603-371-9402
Mailing Address - Fax:603-371-9409
Practice Address - Street 1:116 S RIVER RD UNIT D-2
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110
Practice Address - Country:US
Practice Address - Phone:603-371-9402
Practice Address - Fax:603-371-9409
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH042349-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily