Provider Demographics
NPI:1679237432
Name:LISHMAN, ELIZABETH CAMPBELL (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:CAMPBELL
Last Name:LISHMAN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 MOSS WOODS DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-9162
Mailing Address - Country:US
Mailing Address - Phone:662-347-6017
Mailing Address - Fax:
Practice Address - Street 1:53 MOSS WOODS DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-9162
Practice Address - Country:US
Practice Address - Phone:662-347-6017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904897363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily