Individual
MRS. LACY E CUSHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1622 MARY DUPRE DR, CHATTANOOGA, TN 37421-2538
(423) 432-7686
Mailing address
1622 MARY DUPRE DR, CHATTANOOGA, TN 37421-2538
(423) 432-7686
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0000027377
TN
Other
Enumeration date
06/14/2020
Last updated
06/14/2020
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