Provider Demographics
NPI:1912050394
Name:PRESSNELL, LISA MARIE (MSN-APN)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:MARIE
Last Name:PRESSNELL
Suffix:
Gender:F
Credentials:MSN-APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 REDBUD CIR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-5735
Mailing Address - Country:US
Mailing Address - Phone:870-273-4446
Mailing Address - Fax:
Practice Address - Street 1:1901 WOODSPRINGS RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-0936
Practice Address - Country:US
Practice Address - Phone:870-268-6962
Practice Address - Fax:870-268-1028
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01849363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARQ47506Medicare UPIN