Cook, Lisa Renee

Cook, Lisa Renee is an individual health care provider with primary practice located at 2202 N John B Dennis Hwy Ste 204 , Kingsport TN 37660-5904. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Cook, Lisa Renee can be contacted via phone (423) 224-3300.

Contact Information

Primary practice address
2202 N John B Dennis Hwy Ste 204 Kingsport TN 37660-5904
Fax: (423) 378-5324
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 7598 Tennessee

Profile Details

NPI number 1538163076
LBN Legal business name Cook, Lisa Renee
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Nov 1st, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538163076 NPPES
Tennessee Other 4081495 BCBST
Tennessee MEDICAID 3928741 BCBST

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