Brokaw, Lisa
Brokaw, Lisa is an individual health care provider with primary practice located at 2600 Sixth St Sw Ohio Hospital Based Physician Corp, Canton OH 44710. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Brokaw, Lisa can be contacted via phone (330) 363-7462.Contact Information
Primary practice address
2600 Sixth St Sw Ohio Hospital Based Physician Corp
Canton OH 44710
Phone: (330) 363-7462
Fax: (330) 363-7679
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | RN166143 | Ohio |
Profile Details
| NPI number | 1851352652 |
|---|---|
| LBN Legal business name | Brokaw, Lisa |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 31st, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851352652 | NPPES |
| Ohio | MEDICAID | 0803447 |
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