MEDICARE: LISA ANNE CASE RN

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
1	163W00000X	Registered Nurse	75966	TN

General Provider Information

NPI Number	:	1518753821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA ANNE CASE RN

Provider Business Mailing Address
First Line	:	1910 FIVE OAKS LN
Second Line	:
City	:	MARYVILLE
State	:	TN
Zip	:	37801-3106
Country	:	US
Telephone Number	:	423-240-7966
Fax Number	:

Provider Business Practice Location Address
First Line	:	4409 CHAPMAN HWY STE W
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37920-4326
Country	:	US
Telephone Number	:	865-545-9322
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2025
Last Update Date	:	04/15/2025

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