Provider Demographics
NPI:1578027959
Name:MEYER, LISA CHARLENE (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:CHARLENE
Last Name:MEYER
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:CHARLENE
Other - Last Name:FLINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:COUNCIL GROVE
Mailing Address - State:KS
Mailing Address - Zip Code:66846-1422
Mailing Address - Country:US
Mailing Address - Phone:620-767-6811
Mailing Address - Fax:
Practice Address - Street 1:600 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:COUNCIL GROVE
Practice Address - State:KS
Practice Address - Zip Code:66846-1422
Practice Address - Country:US
Practice Address - Phone:620-767-6811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78638-052363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily