Innis, Lisa Rae

Innis, Lisa Rae is an individual health care provider with primary practice located at 75 Sylvania Dr , Beavercreek OH 45440-3237. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Innis, Lisa Rae can be contacted via phone (937) 320-5050.

Contact Information

Primary practice address
75 Sylvania Dr Beavercreek OH 45440-3237
Phone: (937) 320-5050
Fax: (937) 320-5060
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA17447 California
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 50.001303RX Ohio

Profile Details

NPI number 1922192350
LBN Legal business name Innis, Lisa Rae
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2006
Last updated Aug 24th, 2020 - about 4 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 1922192350 NPPES
Ohio MEDICAID 0385986

Popular Providers