Individual
LISA VANDEKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
110 29TH AVE N STE 202, NASHVILLE, TN 37203-1448
(615) 327-4304
(615) 327-7940
Mailing address
110 29TH AVE N STE 202, NASHVILLE, TN 37203-1448
(615) 327-4304
(615) 327-7940
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN11820
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3636756
—
TN
01
—
4122853
BCBS
TN
01
—
P00352519
RAILROAD MEDICARE
TN
Enumeration date
06/07/2006
Last updated
03/31/2020
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