Individual
LISA W VANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
320 BRISTOL WEST BLVD STE 2C, BRISTOL, TN 37620-8773
(423) 844-1399
(423) 844-1397
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2093
(423) 390-3340
Taxonomy
Speciality
Code
Description
License number
State
364SW0102X
Women's Health Clinical Nurse Specialist
APN17465
TN
367A00000X
Advanced Practice Midwife
Primary
APN17465
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1531783
—
TN
01
—
APN17465
ST LICENSE
TN
01
—
RN189000
ST LICENSE
TN
Enumeration date
03/27/2013
Last updated
05/14/2020
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