| Doctor Name: | LANI L KISHBAUGH |
| NPI Number: | 1336496413 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | SP012253 |
| Business Practice Address: | 4200 Hospital Rd Coal Township, PA - 178669668 |
| Business Phone Number: | 5708989235 |
| Business Fax Number: | 5706444241 |
| Mailing Address: | 4200 Hospital Rd, COAL TOWNSHIP |
| State: | PA |
| Postal Code: | 178669668 |
| Phone Number: | 5708989235 |
| Fax Number: | 5706444241 |
| NPI Enumeration Date: | 08/08/2012 |
| NPI Last Update Date: | 08/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | SP012253 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |