Individual
RENEE MIESELLE LIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2602 MCKINNEY AVE STE 115, DALLAS, TX 75204-0727
(469) 729-7928
Mailing address
4310 DEERE ST, DALLAS, TX 75204-3608
(214) 901-4112
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP145584
TX
363LA2100X
Acute Care Nurse Practitioner
AP145584
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
AP145584
TX
Other
Enumeration date
08/11/2020
Last updated
11/10/2021
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