MRS. LISA M PARK (NPI# 1881950533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881950533 |
| Entity Type | Individual |
| Full Name | MRS. LISA M PARK |
| Credential | FNP |
| Practice Address |
11729 Roe Ave Leawood KS 66211-2605 |
| Mailing Address |
19003 W 163rd Ct Olathe KS 66062-3564 |
| Practice Telephone | 9133458404 |
| Mailing Telephone | 9136452255 |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-04-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
53-75279-101 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245837129 | Lisa Marie Park | Occupational Therapist | 4960 W Argyle St Apt 2, Chicago, IL 60630-4888 | 2020-10-05 |
| 1447866132 | Lisa Yoensil Yoon Park | Nurse Practitioner | 9204 Esperanza, Irvine, CA 92618-1749 | 2020-09-18 |
| 1356763601 | Lisa Jones Park | Behavioral Analyst | 1510 Sunflower Dr, Missoula, MT 59802-3306 | 2014-01-06 |
| 1972130938 | Lisa Kyoun Park | Student in an Organized Health Care Education/Training Program | 75 N Country Rd, Port Jefferson, NY 11777-2190 | 2020-03-26 |
| 1225549082 | Lisa S. Park | Nurse Practitioner | 1301 20th St Ste 150, Santa Monica, CA 90404-2050 | 2017-10-19 |
| 1568857142 | Lisa Park | Surgery | 8700 Beverly Blvd, West Hollywood, CA 90048-1804 | 2015-04-01 |
| 1134484785 | Lisa Park | Optometrist | 3333 Buford Dr, Suite 1030, Buford, GA 30519-4913 | 2012-07-10 |
| 1699982868 | Lisa L Park | Pediatrics | 4400 University Dr, Student Union Building 1, Room 2300, Fairfax, VA 22030-4422 | 2007-05-17 |
| 1619189115 | Lisa Zito Park | Physical Therapist | 110 Elecia Ln, Foley, AL 36535-8970 | 2007-05-04 |
| 1326269358 | Lisa Lynn Park | Social Worker | 1938 Route 6, Carmel, NY 10512-2311 | 2007-05-01 |
| Street Address |
11729 ROE AVE |
| City | LEAWOOD |
| State | KS |
| Zip Code | 66211-2605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811931280 | Kansas Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 11729 Roe Ave, Leawood, KS 66211-2605 | 2006-06-16 |
| 1780061887 | Margaret Dietz | Nurse Practitioner | 11729 Roe Ave, Leawood, KS 66211-2605 | 2015-04-28 |
| 1538506639 | Cheryl Lynn Seacat | Nurse Practitioner | 11729 Roe Ave, Leawood, KS 66211-2605 | 2013-05-29 |
| 1043655400 | Rachel L Brewer | Nurse Practitioner | 11729 Roe Ave, Leawood, KS 66211-2605 | 2013-04-29 |
| 1578907226 | Brooke Nicole Lutz | Nurse Practitioner | 11729 Roe Ave, Leawood, KS 66211-2605 | 2013-04-24 |
| 1205175577 | Mary Renee Walters | Nurse Practitioner | 11729 Roe Ave, Leawood, KS 66211-2605 | 2013-02-06 |
| 1255682639 | Mia Georgann Gallagher | Nurse Practitioner | 11729 Roe Ave, Leawood, KS 66211-2605 | 2012-09-26 |
| 1073880571 | Ashley Maye Rehmsmeyer | Nurse Practitioner | 11729 Roe Ave, Leawood, KS 66211-2605 | 2011-11-28 |
| 1386926699 | Camille Hertzel | Nurse Practitioner | 11729 Roe Ave, Leawood, KS 66211-2605 | 2011-09-13 |
| 1811278526 | Anna Jo Buckley | Nurse Practitioner | 11729 Roe Ave, Leawood, KS 66211-2605 | 2011-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336611821 | Baillie Rose Woydziak | Social Worker | 5805 W 110th Street, Overland Park, KS 66211 | 2018-12-20 |
| 1467920389 | Ku Medwest Ambulatory Surgery Center, LLC | Clinic/Center | 10720 Nall Avenue, Overland Park, KS 66211 | 2018-11-08 |
| 1235615931 | Janice Carollo | Physical Therapy Assistant | 11611 Granada Lane, Leawood, KS 66211 | 2018-07-16 |
| 1720572555 | Trevor Lee Elmer | Physical Therapist | 10777 Nall, 320 - Corporate Medical Plaza Building II, Overland Park, KS 66211 | 2018-06-15 |
| 1043746555 | Overland Park Surgical Suites, LLC | Clinic/Center | 6650 W 110th St Ste 300, Overland Park, KS 66211 | 2017-05-03 |
| 1619313665 | Vcphcs Xiv, LLC | Clinic/Center | 6331 W. 110th Street, Overland Park, KS 66211 | 2013-05-17 |
| 1528334950 | Scott Anthony Hardouin | Surgery | 5100 W 110th St Unit 300, Overland Park, KS 66211 | 2012-03-29 |
| 1386917003 | Children's Physical Therapy Associates | Physical Therapist | 6600 College Boulevard, Suite 307, Overland Park, KS 66211 | 2012-02-10 |
| 1871876250 | Amber Diane Dalzell | Social Worker | 10965 Granada Ln Ste 102, Overland Park, KS 66211 | 2011-09-22 |
| 1912298001 | Stephen Vincent Hiatt | Orthopaedic Surgery | 10701 Nall Avenue, Suite 200, Overland Park, KS 66211 | 2011-04-25 |
| Find all providers in zip 66211 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033745310 | Victoria Comfort Uruak | Nurse Practitioner | 4603 W 122nd St Apt 724, Leawood, KS 66209-4219 | 2020-03-18 |
| 1295277937 | Dena Sims | Nurse Practitioner | 5005 W 131st St, Leawood, KS 66209-1805 | 2016-11-11 |
| 1356700496 | Jennifer Lyne Parks | Nurse Practitioner | 4300 W 133rd St Ste 200, Leawood, KS 66209-3307 | 2016-02-17 |
| 1467844340 | Kimberly Kircher | Nurse Practitioner | 10511 Mission Road, Unit 201, Leawood, KS 66206 | 2015-03-02 |
| 1386058378 | Janet Gianino | Nurse Practitioner | 5420 W 151st St, Leawood, KS 66224-8713 | 2014-06-17 |
| 1598005563 | Elizabeth Brouillette Plummer | Nurse Practitioner | 10511 Mission Rd, Ste 201, Leawood, KS 66206-2708 | 2013-02-27 |
| 1215284971 | Amanda Corinne Woodworth | Nurse Practitioner | 3601 W 133rd St, Leawood, KS 66209-3345 | 2012-08-12 |
| 1558663609 | Melissa Kay Heaton | Nurse Practitioner | 4800 W 135th St Ste 190, Leawood, KS 66224-8721 | 2010-11-23 |
| 1629306766 | Meghan Koch | Nurse Practitioner | 4940b W. 137th St., Leawood, KS 66224-5912 | 2009-12-01 |
| 1477733434 | Erin Buckley | Nurse Practitioner | 11725 Roe Ave, Leawood, KS 66211-2605 | 2007-11-07 |
| Find all providers in LEAWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.