Provider Demographics
NPI:1245892975
Name:ABITZ, LISA MICHELLE (APRN,PMHNP-BC, IBCLC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MICHELLE
Last Name:ABITZ
Suffix:
Gender:F
Credentials:APRN,PMHNP-BC, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 FLEISCHMANN WAY
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-2995
Mailing Address - Country:US
Mailing Address - Phone:775-457-7564
Mailing Address - Fax:
Practice Address - Street 1:775 FLEISCHMANN WAY
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-2995
Practice Address - Country:US
Practice Address - Phone:775-445-7756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL-152304163WL0100X
TX772924163WL0100X
NV854601363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-152304OtherIBLCE