Healthcare Provider Details

I. General information

NPI: 1134531593
Provider Name (Legal Business Name): LISA M CEJKA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5148A MURFREESBORO RD
LA VERGNE TN
37086-1009
US

IV. Provider business mailing address

3553 MEADOWWOOD DR
MURFREESBORO TN
37128-4630
US

V. Phone/Fax

Practice location:
  • Phone: 615-213-2273
  • Fax: 615-213-2271
Mailing address:
  • Phone: 615-604-5305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number18355
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: