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NPI Code Detail

MEDICARE: LISA D FLETCHER MSN FNP

MEDICARE:   LISA D FLETCHER  MSN FNP
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
1363L00000XNurse PractitionerAPN 000007414TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14094019OTHERBC

General Provider Information

NPI Number : 1932101839
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA D FLETCHER MSN FNP
Provider Business Mailing Address
First Line : 1208 EDWARDS ST
Second Line :
City : UNION CITY
State : TN
Zip : 38261-5320
Country : US
Telephone Number : 731-884-8800
Fax Number : 731-884-0240
Provider Business Practice Location Address
First Line : 1208 EDWARDS ST
Second Line :
City : UNION CITY
State : TN
Zip : 38261-5320
Country : US
Telephone Number : 731-884-8800
Fax Number : 731-884-0240
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 01/25/2010

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Directions to “ LISA D FLETCHER MSN FNP” Practice Location

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