Provider Demographics
NPI:1306283577
Name:CHANEY, LISA WALKER (FNP-BC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:WALKER
Last Name:CHANEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24B CAMDEN BYP
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AL
Mailing Address - Zip Code:36726-1770
Mailing Address - Country:US
Mailing Address - Phone:334-882-1919
Mailing Address - Fax:334-636-2280
Practice Address - Street 1:33650 HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:AL
Practice Address - Zip Code:36784-3305
Practice Address - Country:US
Practice Address - Phone:334-636-5311
Practice Address - Fax:334-636-2942
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-077167363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily