Individual
LISA MARIE CLEVELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
618 LIVE OAK, SAN ANTONIO, TX 78202-1932
(210) 223-2944
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 450-9000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP109719
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
AP109719
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376046401
—
TX
01
—
376046402
CSHCN
TX
Enumeration date
03/25/2010
Last updated
03/17/2018
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