Individual
LISA BERTINA CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
2051 HAMILL ROAD, STE 301 A, HIXSON, TN 37343
(423) 870-3376
(423) 877-1387
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(109) 330-0000
(410) 500-4266
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
PA0000001158
TN
363A00000X
Physician Assistant
Primary
C0009929
MD
Other
Enumeration date
08/31/2006
Last updated
06/24/2025
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