Individual
MRS. LISA DIANE FAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
8130 COUNTRY VILLAGE DR, CORDOVA, TN 38016-2087
(901) 566-1002
Mailing address
3092 CHAMBERS CHAPEL RD., ARLINGTON, TN 38002
(901) 870-7681
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
32712
TN
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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