Provider Demographics
NPI:1124015847
Name:HOEHN, LISA K (FNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:K
Last Name:HOEHN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 997
Mailing Address - Street 2:
Mailing Address - City:FLOMATON
Mailing Address - State:AL
Mailing Address - Zip Code:36441-0997
Mailing Address - Country:US
Mailing Address - Phone:251-296-2456
Mailing Address - Fax:251-296-0320
Practice Address - Street 1:174 HIGHWAY 113
Practice Address - Street 2:
Practice Address - City:FLOMATON
Practice Address - State:AL
Practice Address - Zip Code:36441-4556
Practice Address - Country:US
Practice Address - Phone:251-296-2456
Practice Address - Fax:251-296-0320
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR866285363LF0000X
AL1-130280363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP00368675OtherRAILROAD MEDICARE
MS00127119Medicaid
MSP00368675OtherRAILROAD MEDICARE
MS00127119Medicaid