NPI 1790732899 · live from the CMS NPI Registry
Maryann Lisak, RN, MS, PNP
Nurse Practitioner, Psych/Mental Health in Burlington, VT. National Provider Identifier 1790732899, active.
NPI record
| NPI | 1790732899 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Psych/Mental Health 363LP0808X |
| Practice location | 128 Lakeside Ave, Suite 115, Burlington, VT 05401 |
| Practice phone | 802-860-1928 |
| Enumerated | May 27, 2006 |
| Last updated | July 20, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Psych/Mental Health primary | 363LP0808X | 101.0019912 (VT) |
| Nurse Practitioner, Pediatrics | 363LP0200X | 1010019912 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.