Basic Information
| Provider Information | |||||||||
| NPI: | 1063890085 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MUNCY | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | FRANKIE | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 276 FIELDSTONE DR | ||||||||
| Address2: | |||||||||
| City: | JONESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242631215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2765465310 | ||||||||
| FaxNumber: | 2765469701 | ||||||||
| Practice Location | |||||||||
| Address1: | 536 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | APPALACHIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242161723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2765652760 | ||||||||
| FaxNumber: | 2765469706 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2015 | ||||||||
| LastUpdateDate: | 07/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 0024172517 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.