Provider Demographics
NPI:1720734049
Name:ERHARDT, LISA (NP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ERHARDT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2315 LANSINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38139-5247
Mailing Address - Country:US
Mailing Address - Phone:901-240-3574
Mailing Address - Fax:
Practice Address - Street 1:880 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-3409
Practice Address - Country:US
Practice Address - Phone:901-515-9595
Practice Address - Fax:901-515-9878
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN307762086X0206X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology