# BRENDA LIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1467908244
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WX0106X | Occupational Health Registered Nurse | 412294-1 | NY | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 403392 | NY | Yes |

## Other

- **Enumeration date:** 08/31/2016
- **Last updated:** 07/27/2023