| Doctor Name: | MRS. LISA MARIE ROSER |
| NPI Number: | 1023060688 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | R126043 |
| Business Practice Address: | 511 Idlewild Ave Easton, MD - 216013825 |
| Business Phone Number: | 4108226005 |
| Business Fax Number: | 4108229253 |
| Mailing Address: | 511 Idlewild Ave, EASTON |
| State: | MD |
| Postal Code: | 216013825 |
| Phone Number: | 4108226005 |
| Fax Number: | 4108229253 |
| NPI Enumeration Date: | 05/16/2006 |
| NPI Last Update Date: | 07/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | R126043 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |