Healthcare Provider Details

I. General information

NPI: 1609617018
Provider Name (Legal Business Name): LISA MCMILLIAN LIER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 06/03/2024
Certification Date: 06/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US

IV. Provider business mailing address

81 FONTAINEBLEAU DR
NEW ORLEANS LA
70125-3442
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-4023
  • Fax:
Mailing address:
  • Phone: 256-527-4801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number235695
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: