Provider Demographics
NPI:1376902023
Name:HARMON, LISA HOLIDAY (FNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:HOLIDAY
Last Name:HARMON
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 1:16300 KUYKENDAHL RD STE 410
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-2751
Mailing Address - Country:US
Mailing Address - Phone:832-666-7974
Mailing Address - Fax:
Practice Address - Street 1:17007 DAWN SHADOWS DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-4547
Practice Address - Country:US
Practice Address - Phone:832-643-9116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130367363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily