Lisa J Dyer, DNP, APRN, FNP-BC

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN0000067203 Issued in TN

Practice address

77 Stonebridge Blvd
Jackson, TN 38305-2165

Phone

(731) 780-1986

Fax

(731) 984-9939

NPI assigned

Feb 18, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1649419466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 STONEBRIDGE BLVD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052165",
            "telephone_number": "731-780-1986",
            "fax_number": "731-984-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 STONEBRIDGE BLVD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052165",
            "telephone_number": "731-780-1986",
            "fax_number": "731-984-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "LISA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-18",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN0000067203",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "13930",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel W Durham, DC
• John W Duval, MD
• Elizabeth A Dye, PT
• Angela Marie Dyer, OT
• Jeffrey N Dyer, PHYSICAL THERAPIST
• Dyersburg Kidney Clinic, Inc
• E H Dudley, DDS, PLLC
• Each1 Personal Care Services
• Allison Ealey
• James Tyler Earls, RN

• Registered Nurse in Jackson, TN
• Providers in Jackson, TN by specialty
• Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.