Provider Demographics
NPI:1437208600
Name:GEORGE, LISA J (FNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:GEORGE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 HIGHLAND TER STE E
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2485
Mailing Address - Country:US
Mailing Address - Phone:615-893-8885
Mailing Address - Fax:615-893-8142
Practice Address - Street 1:520 HIGHLAND TER STE E
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2485
Practice Address - Country:US
Practice Address - Phone:615-893-8885
Practice Address - Fax:615-893-8142
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN110194OtherRN
TN11986OtherAPN