Lisa Jennifer King CRNP

NPI 1104155605 - Nurse Practitioner - 363L00000X

NPI Details
NPI 1104155605
Gender Female
Enumeration Date 12/11/2009
Last Updated 03/08/2016
Entity Type Individual
Active Over 6 years ago
Practice Location
70 MADISON RD
MANSFIELD OH, 44905-2831, US
Phone (419) 589-9700
Fax (419) 589-2731
Business Location
1025 S TRIMBLE RD
MANSFIELD OH, 44906-3427, US
Phone (419) 589-9700
Fax (419) 589-2103
Toxanomy
Taxonomy Code 363L00000X
License State Ohio
License Number COA.11067-NP
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According to our database, Mrs. Lisa Jennifer King CRNP NPI is 1104155605, taxonomy code is 363L00000X and license number is COA.11067-NP, license state is located at Ohio. Lisa Jennifer King CRNP physically located at 70 Madison Rd, Mansfield OH, 44905-2831. NPI Number Lisa Jennifer King CRNP has the Individual type.

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1104155605 NPI number is provided on an as is basis without warranty of any kind. 1104155605 is maintained by the National Plan & Provider Enumeration System. The contents of Lisa Jennifer King CRNP are for informational purposes only.