MS. MARYANN LISAK (NPI# 1790732899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790732899 |
| Entity Type | Individual |
| Full Name | MS. MARYANN LISAK |
| Credential | RN, MS, PNP |
| Practice Address |
128 Lakeside Ave Suite 115 Burlington VT 05401-4939 |
| Practice Telephone | 8028601928 |
| Mailing Telephone | 8028601928 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2013-10-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
1010019912 | VT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
128 LAKESIDE AVE SUITE 115 |
| City | BURLINGTON |
| State | VT |
| Zip Code | 05401-4939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104880426 | Lakeside Pediatrics, Pllc | Pediatrics | 128 Lakeside Ave, Suite 115, Burlington, VT 05401-4939 | 2006-04-13 |
| 1366051690 | Brianna Kristine Johnson | Nurse Practitioner | 128 Lakeside Ave, Burlington, VT 05401-4939 | 2020-07-22 |
| 1316427743 | Heejung Charron | Nurse Practitioner | 128 Lakeside Ave, Burlington, VT 05401-4939 | 2018-08-15 |
| 1265815690 | Salissa Wahlers | Social Worker | 128 Lakeside Ave, Ste 260, Burlington, VT 05401-4939 | 2015-07-02 |
| 1174880876 | Ashley Boyd | Nurse Practitioner | 128 Lakeside Ave, Suite 115, Burlington, VT 05401-4939 | 2012-04-19 |
| 1649549122 | Fueling Fitness Plc | Dietitian, Registered | 128 Lakeside Ave, Burlington, VT 05401-4939 | 2011-12-29 |
| 1235411174 | Marcia M Bristow | Dietitian, Registered | 128 Lakeside Ave, Burlington, VT 05401-4939 | 2011-09-16 |
| 1366641086 | Gregory Connolly | Pediatrics | 128 Lakeside Ave, Suite 115, Burlington, VT 05401-4939 | 2007-07-12 |
| 1215023635 | Planned Parenthood of Northern New England | Non-Pharmacy Dispensing Site | 128 Lakeside Ave, Ste 301, Burlington, VT 05401-4939 | 2006-10-04 |
| 1902815376 | Tonya Wilkinson | Nurse Practitioner | 128 Lakeside Ave, Suite 115, Burlington, VT 05401-4939 | 2006-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821626748 | John Henry Priester Jr. | Student in an Organized Health Care Education/Training Program | University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT 05401 | 2020-03-27 |
| 1730649054 | Parisa Heidari | Student in an Organized Health Care Education/Training Program | Uvmmc 111 Colchester Avenue, Burlington, VT 05401 | 2019-03-22 |
| 1689141988 | No Diet Dietitian, LLC | Dietitian, Registered | 163 Bayberry Circle #204, Burlington, VT 05401 | 2018-10-25 |
| 1073097267 | Katherine Dwyer | Physical Therapist | 128 Lakeside Ave, Burlington, Vt, 05401, Burlington, VT 05401 | 2018-09-24 |
| 1710469481 | Nicholas A Fredette | Nurse Practitioner | 28 S. Williams St., Burlington, VT 05401 | 2018-08-30 |
| 1760987473 | Tyler Fanning | Psychiatry & Neurology | Uvmmv 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-26 |
| 1356845416 | Rachel Carlson | Student in an Organized Health Care Education/Training Program | Uvmmc, 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-22 |
| 1487152096 | Garnet Transport Medicine, LLC | Ambulance | 70 S Winooski Ave Ste 255, Burlington, VT 05401 | 2018-01-29 |
| 1689172660 | Valerie Goldberg | Dietitian, Registered | 163 Bayberry Circle Apt 204, Burlington, VT 05401 | 2018-01-25 |
| 1548774235 | Emily R Day | Physical Therapist | 160 Flynn Avenue, Burlington, VT 05401 | 2017-11-17 |
| Find all providers in zip 05401 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336484856 | Jamie Swanson | Nurse Practitioner | 219 Austin Dr, Burlington, VT 05401-5428 | 2012-12-10 |
| 1932665684 | Kathleen Morwood Goodwin | Nurse Practitioner | 128 Lakeside Ave Ste 115, Burlington, VT 05401-4936 | 2019-02-19 |
| 1558827832 | Catherine Nichols Mueller | Nurse Practitioner | 3804 S Church St, Burlington, NC 27215-9134 | 2019-02-12 |
| 1104345180 | Laura Fox Landon | Nurse Practitioner | 530 W Webb Ave, Burlington, NC 27217-3706 | 2017-09-12 |
| 1851843338 | Taylor Hall | Nurse Practitioner | 113 Trail One, Burlington, NC 27215-5531 | 2016-10-31 |
| 1033507868 | Nicole Annette Clarke Jagodowski | Nurse Practitioner | 20 Wall St, Burlington, MA 01803-4758 | 2015-01-01 |
| 1265867808 | Kristina Lynn Goetz | Nurse Practitioner | 1900 Burlington Mount Holly Rd, Building One - Suite B, Burlington, NJ 08016-4722 | 2013-09-12 |
| 1174880876 | Ashley Boyd | Nurse Practitioner | 128 Lakeside Ave, Suite 115, Burlington, VT 05401-4939 | 2012-04-19 |
| 1902082977 | Monica Marie Ploof | Nurse Practitioner | 111 Colchester Ave, Smith 568, Burlington, VT 05401-1473 | 2008-01-21 |
| 1902815376 | Tonya Wilkinson | Nurse Practitioner | 128 Lakeside Ave, Suite 115, Burlington, VT 05401-4939 | 2006-08-05 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 05401 |
Please comment or provide details below to improve the information on MS. MARYANN LISAK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.