Gronberg, Lisa C

Gronberg, Lisa C is an individual health care provider with primary practice located at 5653 Frist Blvd Suite 630, Hermitage TN 37076-2062. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Gronberg, Lisa C can be contacted via phone (629) 255-2134.

Contact Information

Primary practice address
5653 Frist Blvd Suite 630 Hermitage TN 37076-2062
Phone: (629) 255-2134
Fax: (629) 255-4156
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1793 Tennessee

Profile Details

NPI number 1215255591
LBN Legal business name Gronberg, Lisa C
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2010
Last updated Oct 23rd, 2017 - about 8 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 1215255591 NPPES
Tennessee MEDICAID Q004820

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