Provider Demographics
NPI:1780842062
Name:CRANWELL-BRUCE, LISA ANN (FNP-C)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANN
Last Name:CRANWELL-BRUCE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 COLLEGE CIRCLE
Mailing Address - Street 2:STUDENT HEALTH SERVICES
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30597
Mailing Address - Country:US
Mailing Address - Phone:706-864-1948
Mailing Address - Fax:
Practice Address - Street 1:82 COLLEGE LN
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533
Practice Address - Country:US
Practice Address - Phone:706-864-1948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN080107363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner