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Individual

LISA M JACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN BC

Contact information

Practice address
2076 LASCASSAS PIKE STE B, MURFREESBORO, TN 37130-2085
(615) 535-0124
(615) 653-4218
Mailing address
2076 LASCASSAS PIKE STE B, MURFREESBORO, TN 37130-2085
(615) 535-0124
(615) 653-4218

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN0000008399
TN

Other

Enumeration date
07/03/2006
Last updated
04/30/2020
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