| Provider / Organization | NPI | Date Certified |
|---|---|---|
| LISA ANN EBERHARDT | 1639796485 | 2020-06-28 |
Lisa Ann Eberhardt [F] graduated in 2020 and primarily specializes in Nurse Practitioner.
Lisa Ann Eberhardt is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1639796485. Registration indicates Lisa Ann Eberhardt is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| PECOS ID | 6608296280 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Ms. Lisa Ann Eberhardt FNP-BC |
| Practice Office Address | 101 JORDAN RD STE 100 TROY, NY US |
| Practice Office Telephone | 5182749126 |
| Mailing Address | 711 TROY SCHENECTADY RD STE 203 LATHAM, NY 121102461 US |
| Business Telephone | 5187833110 |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 345936
NY |