Individual
MRS. LISA OTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
227 CEDAR ST, SEVIERVILLE, TN 37862-3838
(865) 453-1032
Mailing address
3118 LEWELLING CT, KODAK, TN 37764-1683
(865) 933-1121
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN0000152532
TN
Other
Enumeration date
01/26/2007
Last updated
07/08/2007
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