Individual
LISA A WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
315 N WASHINGTON AVE, STE 190, COOKEVILLE, TN 38501-5984
(931) 528-3300
(313) 722-1029
Mailing address
315 N WASHINGTON AVE, STE 190, COOKEVILLE, TN 38501-5984
(931) 528-3300
(313) 722-1029
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN79264
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1512648
—
TN
05
—
1517710
—
TN
05
—
3001286
—
TN
Enumeration date
05/04/2009
Last updated
08/07/2020
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