Provider Demographics
NPI:1215981758
Name:PISNEY, LISA D (ANP)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:D
Last Name:PISNEY
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4702 CHADWICK RD UNIT 12
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-7931
Mailing Address - Country:US
Mailing Address - Phone:804-720-9492
Mailing Address - Fax:
Practice Address - Street 1:3500 E DONALD ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-9203
Practice Address - Country:US
Practice Address - Phone:319-292-7082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1976492363L00000X
WI4043363LA2200X
IAH160768363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN500006095Medicare PIN