Provider Demographics
NPI:1023083920
Name:PIERSON, LISA MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:MICHELLE
Last Name:PIERSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:650 JOEL DR
Mailing Address - Street 2:BLANCHFIELD ARMY COMMUNITY HOSPITAL
Mailing Address - City:FORT CAMPBELL
Mailing Address - State:KY
Mailing Address - Zip Code:42223-5318
Mailing Address - Country:US
Mailing Address - Phone:270-798-8816
Mailing Address - Fax:270-798-8595
Practice Address - Street 1:650 JOEL DR
Practice Address - Street 2:BLANCHFIELD ARMY COMMUNITY HOSPITAL
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-5318
Practice Address - Country:US
Practice Address - Phone:270-798-8816
Practice Address - Fax:270-798-8595
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2025-01-16
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Provider Licenses
StateLicense IDTaxonomies
MDD0051619207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYVAD000Medicare UPIN