Provider Demographics
NPI:1134840911
Name:CREAR, LISHAI TIERRA (APN, FNP-C)
Entity type:Individual
Prefix:
First Name:LISHAI
Middle Name:TIERRA
Last Name:CREAR
Suffix:
Gender:F
Credentials:APN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 ROUTE 66 FL 3
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-2645
Mailing Address - Country:US
Mailing Address - Phone:732-807-0880
Mailing Address - Fax:
Practice Address - Street 1:318 CHRIS GAUPP DR
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-4460
Practice Address - Country:US
Practice Address - Phone:609-404-9900
Practice Address - Fax:609-404-3653
Is Sole Proprietor?:No
Enumeration Date:2022-09-08
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01364500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily