LISA JILL VANDIEMEN FNP NPI 1396041885

NPI Information

NPI: 1396041885
Provider Name: LISA JILL VANDIEMEN, FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
615 CLINIC DR
LONGVIEW, TX
ZIP 75605
Phone: (903) 571-4656
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Lisa Jill Vandiemen, FNP is a family nurse practitioner in Longview, TX with 14 years of experience. Lisa Jill Vandiemen, FNP NPI is 1396041885. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

615 CLINIC DR
LONGVIEW, TX
ZIP 75605-172
Phone: (903) 571-4656
Fax: (903) 881-1994

The NPI 1396041885 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/1/2011 and was last updated on 4/24/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	AP119904	TEXAS	No
2	363LF0000X	Nurse Practitioner	Family	684452	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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