Doctor Name: | LAUREN SAMANTHA LISA |
NPI Number: | 1235597816 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | |
Business Practice Address: | 22576 Rhea County Hwy Suite 1 Spring City, TN - 373815393 |
Business Phone Number: | 4233654486 |
Business Fax Number: | 4233654510 |
Mailing Address: | 22576 Rhea County Hwy, Suite 1 SPRING CITY |
State: | TN |
Postal Code: | 373815393 |
Phone Number: | 4233654486 |
Fax Number: | 4233654510 |
NPI Enumeration Date: | 02/10/2016 |
NPI Last Update Date: | 03/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |