Provider Demographics
NPI:1508994575
Name:HARDISON, LISA D (RN)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:D
Last Name:HARDISON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ASHLEY CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-7441
Mailing Address - Country:US
Mailing Address - Phone:931-762-4620
Mailing Address - Fax:
Practice Address - Street 1:2379 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-4810
Practice Address - Country:US
Practice Address - Phone:931-762-9406
Practice Address - Fax:931-766-1592
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000065095163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse