LISA JILL VANDIEMEN

LONGVIEW, TX
NPI1396041885
Professional NameLISA JILL VAN DIEMEN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: TX  AP119904)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: TX  684452)
Enumeration Date2011-02-01
Last Update Date2024-05-02
Business Address
LISA JILL VANDIEMEN FNP
615 CLINIC DR
LONGVIEW, TX 75605-5172
Phone number: 903-571-4656
Mailing Address
LISA JILL VANDIEMEN FNP
12197 CROSS FENCE TRL
TYLER, TX 75706-4241
Phone number: 903-571-4656