Provider Demographics
NPI:1932357456
Name:PEREIRA-WOOKEE, LISA (FNP)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:PEREIRA-WOOKEE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7430 REMCON CIR
Mailing Address - Street 2:BLDG A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3514
Mailing Address - Country:US
Mailing Address - Phone:915-584-0051
Mailing Address - Fax:915-833-1114
Practice Address - Street 1:7430 REMCON CIR BLDG A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3519
Practice Address - Country:US
Practice Address - Phone:915-584-0051
Practice Address - Fax:915-833-1114
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP117256363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX202132102Medicaid
TX281023YLPSOtherWELLMED PTAN