Provider Demographics
NPI:1891325940
Name:HALLMAN, LISA JO (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:JO
Last Name:HALLMAN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 CAROLINA LANDING DR
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-5529
Mailing Address - Country:US
Mailing Address - Phone:919-817-3851
Mailing Address - Fax:
Practice Address - Street 1:831 W MORGAN ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1613
Practice Address - Country:US
Practice Address - Phone:919-817-3851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHALL68QFE163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent