person
Lyza Tennille Gaines, CRNP
Pediatric Nurse Practitioner in Fort Payne, Alabama
NPI 1518912369

Lyza Tennille Gaines is a Pediatric Nurse Practitioner based in Fort Payne, AL and is specialized in Pediatrics. Lyza Tennille Gaines practices in Fort Payne, AL and has the professional credentials of CRNP. The NPI Number for Lyza Tennille Gaines is 1518912369 and holds a License No. 1-091459 (Alabama).

The current practice location address for Lyza Tennille Gaines is 415 Medical Center Dr Sw, Fort Payne, AL and can be reached out via phone at 256-997-2820 and via fax at 256-997-2890.

Location: 415 Medical Center Dr Sw, Fort Payne, AL, 35968-3421
person
Provider Profile Details
NPI Number
1518912369
Provider Name
Lyza Tennille Gaines
Credential
CRNP
Provider Entity Type
Individual
Gender
Female
Address
415 Medical Center Dr Sw, Fort Payne, AL, 35968-3421
Phone Number
256-997-2820
Fax Number
256-997-2890
Provider Enumeration Date
05/23/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
051533716 05 AL
515-33716 01 AL BCBS
institution
Provider Business Practice Location Address Details
Address
415 Medical Center Dr Sw
City
State
Zip
35968-3421
Phone Number
256-997-2820
Fax Number
256-997-2890
person
Provider Business Mailing Address Details
Address
415 Medical Center Dr Sw
City
State
Zip
35968-3421
Phone Number
256-997-2820
Fax Number
256-997-2890
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
1-091459 (Alabama)
Definition
Definition to come...
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