Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 22512 | TN |
NPI | 1003349556 |
---|---|
Provider Name | Lisa Kahana-Naipo |
First Address | Chattanooga, TN 37404-1192 |
Second Address | Chattanooga, TN 37404-1192 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2017 |
Last Update Date | 28/02/2020 |