Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. NERISSA LICUP, MD
ActiveDR. NERISSA LICUP, MD is a Internal Medicine healthcare provider located in KINGSPORT, Tennessee. NPI 1720269731 is currently active in the NPPES registry. Verify at CMS.
Internal Medicine · KINGSPORT, TN
Registration Details
- NPI Number
- 1720269731
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 19, 2007 (18.744327880903 yrs)
- Last Updated
- Jun 10, 2024
- License
-
46416 (TN)
Practice Information
- Address
-
2205 PAVILION DR STE 101KINGSPORT, TN, 376604641Browse TN providers · Browse ZIP 37660
- Phone
- 4233926000
- Fax
- 4233926030
- Primary Specialty
-
Internal Medicine
207R00000X
- Additional Specialty
- Internal Medicine
Other Internal Medicine Providers in KINGSPORT, TN
| Name | Credential | NPI |
|---|---|---|
| DR. JAMES LOUTHAN | MD | 1477556157 |
| DR. JUDITH WHITE | MD | 1316940018 |
| ANTHONY EVERHART | MD | 1972505279 |
| DR. ERIC SCHWARTZ | MD | 1508868720 |
| DR. JEWEL JOHNNY WHITE | MD | 1871595058 |
| SRINIVAS ANANTHULA | MD | 1992706931 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.