DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: LISA MARIE DEJESUS PMHNP

MEDICARE: LISA MARIE DEJESUS PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN02508RI
2363LP0808XPsychiatric/Mental Health Nurse PractitionerRNRN2272709MA

General Provider Information

NPI Number : 1700410628
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE DEJESUS PMHNP
Provider Business Mailing Address
First Line : 301 STATE AVE
Second Line :
City : TIVERTON
State : RI
Zip : 02878-1062
Country : US
Telephone Number : 774-300-3444
Fax Number : 774-307-9039
Provider Business Practice Location Address
First Line : 301 STATE AVE
Second Line :
City : TIVERTON
State : RI
Zip : 02878-1062
Country : US
Telephone Number : 774-300-3444
Fax Number : 774-307-9039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/29/2020
Last Update Date : 10/08/2025

Similar Medicare Providers

1063858561 — MR. BENJAMIN SEARS RN
Practice Location Address:
301 STATE AVE
TIVERTON, RI
02878-1062
Practice Phone: 774-300-3444
Practice Fax:
1477136513 — HEALING MINDS PSYCHIATRY, LLC
Practice Location Address:
301 STATE AVE
TIVERTON, RI
02878-1062
Practice Phone: 774-300-3444
Practice Fax: 774-307-9039
1154999142 — ANDREA JOY GAGNON RN
Practice Location Address:
301 STATE AVE
TIVERTON, RI
02878-1062
Practice Phone: 402-310-1421
Practice Fax:
1558044164 — KELLY SANTOS APRN, CNP
Practice Location Address:
301 STATE AVE
TIVERTON, RI
02878-1062
Practice Phone: 774-300-3444
Practice Fax: 774-307-9039
1487413720 — JENNIFER GLYNN
Practice Location Address:
301 STATE AVE
TIVERTON, RI
02878-1062
Practice Phone: 774-300-3444
Practice Fax:
1053200279 — KRISTIN BARBER NP
Practice Location Address:
301 STATE AVE
TIVERTON, RI
02878-1062
Practice Phone: 774-300-3444
Practice Fax:

Directions to “ LISA MARIE DEJESUS PMHNP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.