# LISA MARIE DEJESUS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1700410628
- **Gender:** F
- **Credential:** PMHNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | APRN02508 | RI | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | RNRN2272709 | MA | — |

## Other

- **Enumeration date:** 02/29/2020
- **Last updated:** 10/08/2025