Provider Demographics
NPI:1780667006
Name:CLAIBORNE, LISA (RN MSN CS FNP)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:CLAIBORNE
Suffix:
Gender:F
Credentials:RN MSN CS FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:420 COLLEGE ST STE A
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37083-1751
Mailing Address - Country:US
Mailing Address - Phone:615-688-5383
Mailing Address - Fax:888-972-5790
Practice Address - Street 1:420 COLLEGE ST STE A
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:TN
Practice Address - Zip Code:37083-1751
Practice Address - Country:US
Practice Address - Phone:615-688-5383
Practice Address - Fax:888-972-5790
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000005880207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3902597Medicaid
S72109Medicare UPIN