Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 35462 | TN |
NPI | 1003901646 |
---|---|
Provider Name | Lisa Ann Bellner |
First Address | Louisville, TN 37777-0580 |
Second Address | Knoxville, TN 37919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 01/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0717787 | CIGNA (01) | TN |
4104038 | BLUE CROSS/BLUE SHIELD (01) | TN |
41663670 | HUMANA (01) | TN |
5623220001 | PALMETTO (01) | TN |
7152403 | AETNA (01) | TN |
F55785 | (02) | TN |