Provider Demographics
NPI:1952657025
Name:HEARD, LISA (FNP-BC, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:HEARD
Suffix:
Gender:F
Credentials:FNP-BC, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10201 MCPHERSON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6880
Mailing Address - Country:US
Mailing Address - Phone:956-795-1160
Mailing Address - Fax:
Practice Address - Street 1:10201 MCPHERSON RD STE 300
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6880
Practice Address - Country:US
Practice Address - Phone:956-795-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP121179363LP0808X, 363LF0000X
TX728106363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health