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Individual

LISA J ELDRIDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
124 N HENDERSON AVE, SEVIERVILLE, TN 37862-5948
(865) 374-7100
Mailing address
6800 BAUM DR, KNOXVILLE, TN 37919-7315
(865) 374-7100

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002052925
VA

Other

Enumeration date
01/14/2010
Last updated
01/14/2010
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