Provider Demographics
NPI:1083615868
Name:DUGGER, LISA A (NP)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:A
Last Name:DUGGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1940 ALCOA HWY
Mailing Address - Street 2:SUITE E-310
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-2244
Mailing Address - Country:US
Mailing Address - Phone:865-544-2800
Mailing Address - Fax:865-544-6812
Practice Address - Street 1:1940 ALCOA HWY
Practice Address - Street 2:SUITE E-310
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-2244
Practice Address - Country:US
Practice Address - Phone:865-544-2800
Practice Address - Fax:865-544-6812
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN71328363LA2200X
TN6089363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3904342Medicaid
TN3904342Medicare ID - Type Unspecified
TN3904342Medicaid