MEDICARE: LISA RENEE NOBLE FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	ARNP9272218	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568804862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA RENEE NOBLE FNP-C

Provider Business Mailing Address
First Line	:	218 SOUTHARD ST
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-8319
Country	:	US
Telephone Number	:	772-708-8077
Fax Number	:	305-395-7913

Provider Business Practice Location Address
First Line	:	3138 NORTHSIDE DR STE B
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-8009
Country	:	US
Telephone Number	:	305-395-7677
Fax Number	:	305-395-7913

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2013
Last Update Date	:	06/13/2024

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