Provider Demographics
NPI:1316053887
Name:LAMPMAN, LISA (CNS-RN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:LAMPMAN
Suffix:
Gender:F
Credentials:CNS-RN
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:RENEE
Other - Last Name:FELGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNS-RN
Mailing Address - Street 1:1007 MO PAC CIR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6864
Mailing Address - Country:US
Mailing Address - Phone:512-300-2455
Mailing Address - Fax:512-300-2454
Practice Address - Street 1:1007 MO PAC CIR
Practice Address - Street 2:SUITE 201
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6864
Practice Address - Country:US
Practice Address - Phone:512-300-2455
Practice Address - Fax:512-300-2454
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX664485364SA2200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164425401Medicaid
TXQ11983Medicare UPIN
TX164425401Medicaid