Provider Demographics
NPI:1811441876
Name:REID, LISA MARY (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARY
Last Name:REID
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARY
Other - Last Name:LOISELLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:2100 HEDGCOXE RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3156
Mailing Address - Country:US
Mailing Address - Phone:972-769-8443
Mailing Address - Fax:
Practice Address - Street 1:2100 HEDGCOXE RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3156
Practice Address - Country:US
Practice Address - Phone:972-769-8443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-08
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131323363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily