Provider Demographics
NPI:1376594259
Name:GINAPP, LISA A (AGACNP, WCC,DWC,OMS)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:A
Last Name:GINAPP
Suffix:
Gender:F
Credentials:AGACNP, WCC,DWC,OMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 LANIER DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-4716
Mailing Address - Country:US
Mailing Address - Phone:281-923-4315
Mailing Address - Fax:844-927-4325
Practice Address - Street 1:8900 EMMETT F LOWRY EXPY STE 200
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-9119
Practice Address - Country:US
Practice Address - Phone:281-923-4315
Practice Address - Fax:844-927-4325
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP113811363LA2100X, 363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX525674OtherRN APN LICENSE
TX174351005Medicaid
TX12638858OtherCAQH
TXAP113811OtherADVANCED PRACTICE REGISTERED NURSE
TX1743510Medicaid