Look up the most recent NPI and PECOS records

Lisa Marie Neuenfeldt

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2100 State Ave, Panama City, FL 32405-4587

PECOS Enrollment

This provider is enrolled in PECOS as LISA NEUENFELDT.

Based on the most recent information from CMS, provider Lisa Marie Neuenfeldt is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1619290673
Provider Type
Individual
Full Name
Neuenfeldt, Lisa Marie
Title
Ms.
Credential
APRN

Gender
Female
Sole Proprietor
No
Enumeration Date
3/4/2010
Last Updated
2/27/2023

Contact Information

Practice Location

2100 State Ave, Panama City, FL 32405-4587

(850) 763-0036

(850) 763-0259

Mailing Location

2422 Breezy Ln, Panama City, FL 32405-3917

(850) 258-7340

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License APRN9185753 Florida
Code 364SX0200X	Description Clinical Nurse Specialist Physician Assistants & Advanced Practice Nursing Providers	License ARNP9185753 Florida
Code 363LA2200X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License ARNP9185753 Florida

Provider Identifiers

ID	Description	Issuer
ID 003619000	Description Medicaid	Issuer Unlisted Florida

Lisa Marie Neuenfeldt

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Ferris, Bruce Franklin

White, Brittney Marie

Mears, Elizabeth Ashley

Tafunai, Evie-Noel

Cook, Trevor Eugene

Andrews, Mary M

Roberts, Doris M

Ruano Olivero, Anaiya D

Azzati, Michele Genevieve

Miller, Denise A