NPI 1366525826 · live from the CMS NPI Registry
Lisa Marie Anderson, PA-C
Physician Assistant in Augusta, ME. National Provider Identifier 1366525826, active.
NPI record
| NPI | 1366525826 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 10 Whitten Rd, Augusta, ME 04330 |
| Practice phone | 207-466-2400 |
| Mailing address | 360 Us Highway 1 Byp Unit 102, Portsmouth, NH 03801 |
| Enumerated | October 20, 2006 |
| Last updated | November 14, 2023 |
| Sole proprietor | No |
| Other names | Lisa Gourley |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | PA1830 (ME) |
| Physician Assistant | 363A00000X | C0003392 (MD) |
| Physician Assistant, Medical | 363AM0700X | C0003392 (MD) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.