Individual
LISA C GRONBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
325 OLD PLEASANT GROVE RD, MOUNT JULIET, TN 37122-4493
(629) 255-2134
(629) 255-4156
Mailing address
222 22ND AVE N, NASHVILLE, TN 37203-1852
(629) 255-3486
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1793
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q004820
—
TN
Enumeration date
05/11/2010
Last updated
12/20/2024
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