Provider Demographics
NPI:1780411876
Name:CHRISTIAN, LISA F (LPN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:F
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 E CHAPMAN RD
Mailing Address - Street 2:
Mailing Address - City:LA FOLLETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37766-7905
Mailing Address - Country:US
Mailing Address - Phone:423-907-2143
Mailing Address - Fax:
Practice Address - Street 1:380 E CHAPMAN RD
Practice Address - Street 2:
Practice Address - City:LA FOLLETTE
Practice Address - State:TN
Practice Address - Zip Code:37766-7905
Practice Address - Country:US
Practice Address - Phone:423-907-2143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36886164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse