Provider Demographics
NPI:1982771226
Name:FORTE, LISA M (ACNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:FORTE
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
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Mailing Address - Street 1:2004 HAYES ST STE 800
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2659
Mailing Address - Country:US
Mailing Address - Phone:615-329-0570
Mailing Address - Fax:615-320-7091
Practice Address - Street 1:103 PHYSICIANS WAY STE 120
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37090-4134
Practice Address - Country:US
Practice Address - Phone:615-453-5623
Practice Address - Fax:615-453-8592
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2020-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN0000012385363L00000X
TNRN151900363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner