Provider Demographics
NPI:1518208784
Name:ADDEA-AMOAKO, LISELOTTE (FNP, DNP)
Entity Type:Individual
Prefix:DR
First Name:LISELOTTE
Middle Name:
Last Name:ADDEA-AMOAKO
Suffix:
Gender:F
Credentials:FNP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 HIGHWAY 157 N
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-4847
Mailing Address - Country:US
Mailing Address - Phone:817-813-8055
Mailing Address - Fax:
Practice Address - Street 1:2140 HIGHWAY 157 N
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-4847
Practice Address - Country:US
Practice Address - Phone:817-813-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP123279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily