Provider Demographics
NPI:1043867914
Name:HERRERA, LIZBETH LAURA (MNSC, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:LIZBETH
Middle Name:LAURA
Last Name:HERRERA
Suffix:
Gender:F
Credentials:MNSC, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CROSSETT
Mailing Address - State:AR
Mailing Address - Zip Code:71635-2928
Mailing Address - Country:US
Mailing Address - Phone:870-305-1221
Mailing Address - Fax:870-364-9774
Practice Address - Street 1:1906 W HILLSBORO ST
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-6806
Practice Address - Country:US
Practice Address - Phone:870-639-9322
Practice Address - Fax:501-235-3743
Is Sole Proprietor?:No
Enumeration Date:2019-08-24
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR121647363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health