| Doctor Name: | MS. LISSA WEST |
| NPI Number: | 1003055955 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 115113 R.N. |
| Business Practice Address: | 111 Otis Smith Dr Clarksville, TN - 370438940 |
| Business Phone Number: | 9315536666 |
| Business Fax Number: | 9315534006 |
| Mailing Address: | 111 Otis Smith Dr, CLARKSVILLE |
| State: | TN |
| Postal Code: | 37043 |
| Phone Number: | 9315536666 |
| Fax Number: | 9315534006 |
| NPI Enumeration Date: | 02/17/2009 |
| NPI Last Update Date: | 08/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0200X |
| License Number: | 115113 R.N. |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |