Individual
LISA JOY LUNSFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1005 STATE HIGHWAY 16 S, GRAHAM, TX 76450
(612) 801-1392
Mailing address
1005 STATE HIGHWAY 16 S, GRAHAM, TX 76450-3835
(612) 801-1392
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
AP115683
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
AP115683
TX
363LP2300X
Primary Care Nurse Practitioner
733838
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190555601
—
TX
01
—
190555605
CSHCN
TX
Enumeration date
10/02/2007
Last updated
09/19/2019
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