Individual provider · Type 1 NPI
Lisa Ann Tiebauer, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Jacksonville, NC
NPI number
1700069044
Active
Practice location
200 Tarpon Trl
Jacksonville, NC 28546-5287
Fax (910) 938-1118
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 5005198 (NC) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1700069044
Lisa Ann Tiebauer, PMHNP-BC's National Provider Identifier is 1700069044, issued on Dec 10, 2007. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Jacksonville, NC. The record was last updated on Mar 7, 2023.