Provider Demographics
NPI:1194334953
Name:SCHNEIDER, LISA
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 ALPHA CT N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6805
Mailing Address - Country:US
Mailing Address - Phone:561-339-3391
Mailing Address - Fax:
Practice Address - Street 1:1840 FOREST HILL BLVD STE 201
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6059
Practice Address - Country:US
Practice Address - Phone:561-337-4033
Practice Address - Fax:567-337-4080
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008209363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily