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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1851352652 NPPES
Ohio MEDICAID 0803447

Popular Providers