| Doctor Name: | LISA R TITTLE |
| NPI Number: | 1073582615 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | F.N.P. |
| License Number: | APN8418 |
| Business Practice Address: | 758 S Willow Ave Cookeville, TN - 385013840 |
| Business Phone Number: | 9315266173 |
| Business Fax Number: | 9315265084 |
| Mailing Address: | 758 S Willow Ave, COOKEVILLE |
| State: | TN |
| Postal Code: | 385013840 |
| Phone Number: | 9315266173 |
| Fax Number: | 9315265084 |
| NPI Enumeration Date: | 03/16/2006 |
| NPI Last Update Date: | 12/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | APN8418 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |