Provider Demographics
NPI:1215486279
Name:TRENT, LISA ANN (FNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:TRENT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 850
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37857-0850
Mailing Address - Country:US
Mailing Address - Phone:423-733-2131
Mailing Address - Fax:423-733-1055
Practice Address - Street 1:1861 MAIN ST
Practice Address - Street 2:
Practice Address - City:SNEEDVILLE
Practice Address - State:TN
Practice Address - Zip Code:37869-3645
Practice Address - Country:US
Practice Address - Phone:423-733-2131
Practice Address - Fax:423-733-1055
Is Sole Proprietor?:No
Enumeration Date:2016-09-30
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21816363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily