Individual
MRS. HEATHER LISI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
989 BURNT TAVERN RD, BRICK, NJ 08724-2014
(732) 320-1366
Mailing address
989 BURNT TAVERN RD, BRICK, NJ 08724-2014
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ01016300
NJ
363LF0000X
Family Nurse Practitioner
APRN11014612
FL
363LF0000X
Family Nurse Practitioner
F349503-01
NY
Other
Enumeration date
03/24/2020
Last updated
12/29/2023
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