Provider Demographics
NPI:1306430509
Name:NEWMAN, LISA MICHELLE (APRN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MICHELLE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7345 W AGATE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-6254
Mailing Address - Country:US
Mailing Address - Phone:702-899-1145
Mailing Address - Fax:702-899-1512
Practice Address - Street 1:7345 W AGATE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-6254
Practice Address - Country:US
Practice Address - Phone:702-899-1145
Practice Address - Fax:702-899-1512
Is Sole Proprietor?:No
Enumeration Date:2021-02-27
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN61402163WC0200X
NV850359363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine