Individual
MS. LISA W GRESSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
119 E FORT ST, MANCHESTER, TN 37355-1508
(931) 728-4477
Mailing address
119 E FORT ST, MANCHESTER, TN 37355-1508
(931) 728-4477
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA0000000727
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1509873
—
TN
01
—
4191422
BCBS OF TN
TN
Enumeration date
01/10/2007
Last updated
08/08/2011
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