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1700069044
LISA ANN TIEBAUER
JACKSONVILLE, NC
NPI
1700069044
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NC 5005198)
Enumeration Date
2007-12-10
Last Update Date
2023-03-07
Business Address
Mrs. LISA ANN TIEBAUER PMHNP-BC
200 TARPON TRL
JACKSONVILLE, NC 28546-5287
Phone number: 910-938-1114
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Mailing Address
Mrs. LISA ANN TIEBAUER PMHNP-BC
200 TARPON TRL
JACKSONVILLE, NC 28546-5287
Phone number: 910-938-1114
Copy
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