Provider Demographics
NPI:1891823845
Name:CARDONA, LISBEDTH (APRN BC)
Entity Type:Individual
Prefix:
First Name:LISBEDTH
Middle Name:
Last Name:CARDONA
Suffix:
Gender:F
Credentials:APRN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 RISING SUN LANE
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138
Mailing Address - Country:US
Mailing Address - Phone:615-541-0819
Mailing Address - Fax:
Practice Address - Street 1:1614 WELLINGTON GRN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-5359
Practice Address - Country:US
Practice Address - Phone:615-794-1814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006465363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3928356Medicaid
TN3928356Medicaid