Shelly, Lisa

Shelly, Lisa is an individual health care provider with primary practice located at 2213 Cherry St , Toledo OH 43608-2603. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as her primary health care specialty. Shelly, Lisa can be contacted via phone (491) 251-4283.

Contact Information

Primary practice address
2213 Cherry St Toledo OH 43608-2603
Phone: (491) 251-4283
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X COA.03100-NP Ohio
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X APRN.CNP.03100 Ohio

Profile Details

NPI number 1619368594
LBN Legal business name Shelly, Lisa
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 12th, 2015
Last updated Jan 11th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619368594 NPPES
Ohio MEDICAID 0122109

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