Provider Demographics
NPI:1780126516
Name:DUNSON, LISA JONELLE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:JONELLE
Last Name:DUNSON
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3234 RAMBLING OAKS DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-4709
Mailing Address - Country:US
Mailing Address - Phone:405-206-7446
Mailing Address - Fax:
Practice Address - Street 1:231 E SYMMES ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6028
Practice Address - Country:US
Practice Address - Phone:405-579-5800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK69922363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily