Provider Demographics
NPI:1649928243
Name:CARNES, LISA MARIE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:CARNES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2565 RIO RICO CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-6213
Mailing Address - Country:US
Mailing Address - Phone:775-379-3937
Mailing Address - Fax:
Practice Address - Street 1:2565 RIO RICO CT
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-6213
Practice Address - Country:US
Practice Address - Phone:775-379-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-13
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV852109363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty