NPI Database
Lookup NPI Numbers from the NPI Registry

Contact Information

NERISSA LICUP, MD
2205 PAVILION DR STE 101
KINGSPORT, TN37660-4641
 Phone: 423-392-6000
 Fax: 423-392-6030
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for NERISSA LICUP · (Female)

NPI # 1720269731
Status Active
Credentials MD
Entity Individual
Enumeration date 11/19/2007
Last updated 06/10/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • TN License # 46416
  • TN Medicaid 1521020
  • VA Medicaid 1720269731
  • TN Other 4276956 BLUECARE
  • TN Other P01015971 RR MEDICARE
Hospital affiliation(s)
  • FRANKLIN WOODS COMMUNITY HOSPITAL - (Acute Care)
    300 MED TECH PARKWAY
    JOHNSON CITY, TN 37604
  • INDIAN PATH MEDICAL CENTER - (Acute Care)
    2000 BROOKSIDE DR
    KINGSPORT, TN 37660
  • JOHNSON CITY MEDICAL CENTER - (Acute Care)
    400 N STATE OF FRANKLIN RD
    JOHNSON CITY, TN 37604
  • UNICOI COUNTY MEMORIAL HOSPITAL - (Acute Care)
    GREENWAY CIRCLE
    ERWIN, TN 37650
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for NERISSA LICUP

Thanks - Your review has been submitted! Please note that if we find that this review has violated our terms or is simply deemed unacceptable, we will remove it without notice.

There are currently no reviews for NERISSA LICUP
Be the first to post a comment or review.


Read our reviews / comments about this provider to help you decide if they are right for you. Share your experience by posting a comment or review about this provider to help others decide which is right for them.

Nearby Doctors & Physicians
JASON DELLA VECCHIA MD PLLC
1700 PINEBROOK DR STE 4
KINGSPORT, TN
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
410 N STATE OF FRANKLIN RD
JOHNSON CITY, TN
NOEL P CURCIO, DO
400 N STATE OF FRANKLIN RD RM 2746
JOHNSON CITY, TN
SYED G HASAN, DO
ETSU PSYCHIATRY AND BEHAVIORAL SCIENCES DEPARTMENT
JOHNSON CITY, TN
TAYLOR LYNCH
1081 JOHN ROBERT BELL DRIVE
JOHNSON CITY, TN
MONIKA JAIN
178 MAPLE AVE
MOUNTAIN HOME, TN
SHEEBA ANAND, MD
325 N STATE OF FRANKLIN
JOHNSON CITY, TN
THOMAS M ROY, MD
CORNER OF SIDNEY AND LAMONT
MOUNTAIN HOME, TN
JOHN M DANIEL, DO
400 N. STATE OF FRANKLIN RD.
JOHNSON CITY, TN

  View all Doctors & Physicians
v2.403