Provider Demographics
NPI:1730526252
Name:TRYON, LILLIAN JANET (FNP-BC)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:JANET
Last Name:TRYON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5731 SUNBURST CT
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-4319
Mailing Address - Country:US
Mailing Address - Phone:610-823-9385
Mailing Address - Fax:
Practice Address - Street 1:127 JORDAN DR STE 101
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-6774
Practice Address - Country:US
Practice Address - Phone:423-250-5094
Practice Address - Fax:423-373-8585
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17534363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily