Provider Demographics
NPI:1124732334
Name:CISNEROS, LIZETTE (FNP)
Entity type:Individual
Prefix:
First Name:LIZETTE
Middle Name:
Last Name:CISNEROS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PROVIDENCIA CT STE 3
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-7453
Mailing Address - Country:US
Mailing Address - Phone:956-413-6162
Mailing Address - Fax:
Practice Address - Street 1:10 PROVIDENCIA CT STE 3
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-7453
Practice Address - Country:US
Practice Address - Phone:956-413-6162
Practice Address - Fax:877-396-1196
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1106736363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily