Lisa Crass

Individual provider Active NPI Licensed Practical Nurse · Harriman, TN

NPI 1649947664 · NPPES record last updated Aug 26, 2021

Key facts

NPI
1649947664
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
LPN0000037109 (TN)
Practice address
125 Starboard CT
Harriman, TN 37748-4529
Phone
(423) 539-8018
NPI assigned
Aug 26, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPN0000037109TNMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN0000037109 TN Yes

Addresses

Primary practice location

125 Starboard CT
Harriman, TN 37748-4529

Mailing address

125 Starboard CT
Harriman, TN 37748-4529

Other providers in Harriman, TN

All providers in Harriman, TN · Licensed Practical Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.