Healthcare Provider Details

I. General information

NPI: 1245174879
Provider Name (Legal Business Name): LISA G ASBURY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COURTHOUSE SQ
FAYETTE MO
65248-1299
US

IV. Provider business mailing address

1 COURTHOUSE SQ
FAYETTE MO
65248-1299
US

V. Phone/Fax

Practice location:
  • Phone: 660-248-5161
  • Fax: 660-248-5009
Mailing address:
  • Phone: 660-248-5161
  • Fax: 660-248-5009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: