Stout, Lisa E.

Stout, Lisa E. is an individual health care provider with primary practice located at 1249 Suncrest Town Centre Dr , Morgantown WV 26505-1876. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Midwife, Nursing Service Providers / Registered Nurse. Other Service Providers / Midwife is her primary health care specialty. Stout, Lisa E. can be contacted via phone (304) 599-6353.

Contact Information

Primary practice address
1249 Suncrest Town Centre Dr Morgantown WV 26505-1876
Phone: (304) 599-6353
Fax: (304) 598-3608
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Midwife 176B00000X 72000124A Indiana
Other Service Providers / Midwife 176B00000X 161 West Virginia
Nursing Service Providers / Registered Nurse 163W00000X 75886 West Virginia

Profile Details

NPI number 1952502064
LBN Legal business name Stout, Lisa E.
Credentials CNM, MSN
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2007
Last updated Apr 19th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952502064 NPPES
Indiana MEDICAID 200866740
Indiana Other 000000522422

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