| Doctor Name: | LISA KNEEDLER |
| NPI Number: | 1063578003 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RNC, NNP |
| License Number: | 680269 |
| Business Practice Address: | 1301 Pennsylvania Ave Ft Worth, TX - 761042122 |
| Business Phone Number: | 8172502892 |
| Business Fax Number: | |
| Mailing Address: | 204 Stanford Ct, HEATH |
| State: | TX |
| Postal Code: | 750326614 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/27/2006 |
| NPI Last Update Date: | 03/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LN0005X |
| License Number: | 680269 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Neonatal, Critical Care |
| Taxonomy Definition: | |