Provider Demographics
NPI:1164225215
Name:ELIA, LISA (APRN-CNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ELIA
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 CLINITE GROVE BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-2354
Mailing Address - Country:US
Mailing Address - Phone:254-314-8699
Mailing Address - Fax:
Practice Address - Street 1:201 CLINITE GROVE BLVD STE 130
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-2354
Practice Address - Country:US
Practice Address - Phone:254-314-8699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1194101207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine