Lisa Proctor, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

F430338 Issued in NY

Practice address

310 Taughannock Blvd
Ithaca, NY 14850-3251

Phone

(607) 252-3590

NPI assigned

Apr 17, 2007

Last updated

Feb 21, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298246400000",
    "number": "1114143419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 VANWOERT RD",
            "city": "SPENCER",
            "state": "NY",
            "postal_code": "148839721",
            "telephone_number": "607-589-6826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 TAUGHANNOCK BLVD",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503251",
            "telephone_number": "607-252-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "LISA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2011-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F430338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acute Care Nurse Practitioner in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.