Provider Demographics
NPI:1437740248
Name:MONTEVERDE, LISA TORREY (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:TORREY
Last Name:MONTEVERDE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:TORREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4431 LOYOLA AVE APT A
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-5966
Mailing Address - Country:US
Mailing Address - Phone:816-518-4127
Mailing Address - Fax:
Practice Address - Street 1:519 METAIRIE RD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4311
Practice Address - Country:US
Practice Address - Phone:504-838-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA218468363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine