Provider Demographics
NPI:1265933766
Name:MEDHUS, LILLIAN ELIZABETH (DNP, WHNP-BC, CNM)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:ELIZABETH
Last Name:MEDHUS
Suffix:
Gender:F
Credentials:DNP, WHNP-BC, CNM
Other - Prefix:
Other - First Name:LILLIAN
Other - Middle Name:ELIZABETH
Other - Last Name:MEYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:464 SUGARLANDS DR
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-9595
Mailing Address - Country:US
Mailing Address - Phone:510-461-8096
Mailing Address - Fax:
Practice Address - Street 1:464 SUGARLANDS DR
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-9595
Practice Address - Country:US
Practice Address - Phone:510-461-8096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5740363LW0102X
367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health