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General NPI Number Information
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NPI Number | 1962805028
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Entity Type | Individual
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Provider Name | LISA CRANE PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2014
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 3841 MIDWAY PL NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-5814
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Country | US
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Telephone | 505-429-1792
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Fax |
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Provider Business Mailing Address
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Address Line | 13451 STONE VIEW DR
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City | AMARILLO
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State | TX
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Zip | 79124-4681
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Country | US
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Telephone | 575-708-1438
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1123009
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | CNP-02650
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License Number State | NM
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