Healthcare Provider Details
I. General information
NPI: 1912050394
Provider Name (Legal Business Name): LISA MARIE PRESSNELL MSN-APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/19/2007
Last Update Date: 11/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1901 WOODSPRINGS RD
JONESBORO AR
72401-0936
US
IV. Provider business mailing address
1424 REDBUD CIR
JONESBORO AR
72401-5735
US
V. Phone/Fax
- Phone: 870-268-6962
- Fax: 870-268-1028
- Phone: 870-273-4446
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | A01849 |
| License Number State | AR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | A01849 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: