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Individual

MRS. LISA THOMPSON VIDEAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
8144 WALNUT HILL LN, DALLAS, TX 75231-4388
(214) 785-2200
Mailing address
240 RALEIGH DR, SLIDELL, LA 70460-8805
(504) 296-1620

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
RN0077394
LA
363L00000X
Nurse Practitioner
6145
LA
363L00000X
Nurse Practitioner
Primary
AP06145
LA
363LF0000X
Family Nurse Practitioner
APRN3399092
FL
363LF0000X
Family Nurse Practitioner
RN077394-AP06145
LA

Other

Enumeration date
06/02/2010
Last updated
06/09/2015
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