Provider Demographics
NPI:1285091751
Name:GOANS, LISA R (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:R
Last Name:GOANS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11936 DIAMOND ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:WADESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47638-9628
Mailing Address - Country:US
Mailing Address - Phone:502-938-8014
Mailing Address - Fax:
Practice Address - Street 1:5120 WESTON RD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-3702
Practice Address - Country:US
Practice Address - Phone:812-424-4811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2017-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71006082A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily