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NPI Code Detail

MEDICARE: LISA NICOLE TRAIL ANP-BC

MEDICARE: LISA NICOLE TRAIL ANP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner14229TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174751671
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA NICOLE TRAIL ANP-BC
Provider Business Mailing Address
First Line : 3325 SHORES RD
Second Line :
City : MURFREESBORO
State : TN
Zip : 37128-3616
Country : US
Telephone Number : 615-556-8889
Fax Number :
Provider Business Practice Location Address
First Line : 3325 SHORES RD
Second Line :
City : MURFREESBORO
State : TN
Zip : 37128-3616
Country : US
Telephone Number : 615-556-8889
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2009
Last Update Date : 05/19/2026

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