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1407520786
LISA DUNIVAN KING
JACKSON, TN
NPI
1407520786
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TN 28972)
Enumeration Date
2021-08-02
Last Update Date
2021-08-02
Business Address
LISA DUNIVAN KING NP
1605 S HIGHLAND AVE
JACKSON, TN 38301-7718
Phone number: 731-424-9741
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Mailing Address
LISA DUNIVAN KING NP
375 PEDDY VESTAL LOOP
HENDERSON, TN 38340-3492
Phone number: 731-695-4439
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