Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Lisa Ann Tiebauer, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1700069044

Mrs. Lisa Ann Tiebauer, PMHNP-BC is a Nurse Practitioner in Jacksonville, North Carolina. Qualified in 2005, 21 years ago. Practices with Coastal Carolina Neuropsychiatric Center PA, a 28-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
21
Licensed in
NC
In the registry since
2007
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

200 Tarpon Trl
Jacksonville, NC 28546-5287
Phone: (910) 938-1114
Fax: (910) 938-1118
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 5005198 (NC)

Record details

NPI number1700069044
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC
Sole proprietorNo
NPI enumeratedDecember 10, 2007
Last updated in NPPESMarch 7, 2023
Certification dateMarch 7, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Coastal Carolina Neuropsychiatric Center Pa — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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