Lisa Leann Emmendorfer, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

5004964 Issued in NC

Practice address

705 Landa St
Site C
New Braunfels, TX 78130-6172

Phone

(830) 643-0717

Fax

(830) 629-2438

NPI assigned

Nov 2, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1508166810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 E COMMON ST",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781306059",
            "telephone_number": "830-730-8580",
            "fax_number": "830-321-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 LANDA ST",
            "address_2": "SITE C",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781306172",
            "telephone_number": "830-643-0717",
            "fax_number": "830-629-2438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMENDORFER",
        "first_name": "LISA",
        "middle_name": "LEANN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP121779",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5004964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in New Braunfels, TX
• Providers in New Braunfels, TX by specialty
• Adult Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.