Healthcare Provider Details

I. General information

NPI: 1477881415
Provider Name (Legal Business Name): LISA M. GUNN-BESHEARS ARNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2009
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 TOWNE DR
ELIZABETHTOWN KY
42701-8460
US

IV. Provider business mailing address

8 CADILLAC DR STE. 250
BRENTWOOD TN
37027-5087
US

V. Phone/Fax

Practice location:
  • Phone: 270-765-3488
  • Fax: 270-765-3484
Mailing address:
  • Phone: 615-425-4287
  • Fax: 615-425-4271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6259P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: