Provider Demographics
NPI:1700485950
Name:FITE, LISA A (MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:FITE
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 AIR PARK AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-3000
Mailing Address - Country:US
Mailing Address - Phone:903-408-5834
Mailing Address - Fax:903-408-5693
Practice Address - Street 1:4001 RIDGECREST RD STE B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402-6143
Practice Address - Country:US
Practice Address - Phone:903-453-2870
Practice Address - Fax:903-453-2879
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1016507363LP0808X
TX696766363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner