Individual
LISA LAVON FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC, CPNP
Contact information
Practice address
5434 W WALSH LN, ROGERS, AR 72758-8946
(479) 443-5575
Mailing address
PO BOX 2292, ROGERS, AR 72757-2292
(479) 684-6776
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
A004072
AR
363LP0200X
Pediatric Nurse Practitioner
AP126713
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
A004072
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215333075
—
MO
05
—
200697640
—
OK
05
—
210116758
—
AR
Enumeration date
11/06/2014
Last updated
01/10/2020
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