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General NPI Number Information
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NPI Number | 1174097810
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Entity Type | Individual
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Provider Name | LISA NELSON DNP
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Gender | Female
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Dates
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Enumeration Date | 01/16/2019
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Last Update Date | 12/31/2019
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Provider Practice Location Address
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Address Line | 20 NE SAINT LUKES BLVD STE 350
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City | LEES SUMMIT
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State | MO
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Zip | 64086-6007
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Country | US
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Telephone | 816-347-5600
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Fax | 816-347-5674
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Provider Business Mailing Address
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Address Line | 20 NE SAINT LUKES BLVD STE 350
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City | LEES SUMMIT
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State | MO
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Zip | 64086-6007
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Country | US
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Telephone | 816-347-5600
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Fax | 816-347-5674
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 14-125543031
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2012017308
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License Number State | MO
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