Individual
MRS. THERESA RAE LISENBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,CEO, INSTRUCTOR
Contact information
Practice address
7471 FM 3094, SCURRY, TX 75158-4915
(972) 452-3337
(972) 452-3331
Mailing address
7471 FM 3094, SCURRY, TX 75158-4915
(972) 452-3337
(972) 452-3331
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
572628
TX
174400000X
Specialist
—
—
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
—
—
225800000X
Recreation Therapist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/29/2008
Last updated
01/29/2008
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