Provider Demographics
NPI:1194319889
Name:LENGERICH, LISA (CNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:LENGERICH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10450 NEW HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030-2780
Mailing Address - Country:US
Mailing Address - Phone:513-981-5852
Mailing Address - Fax:513-367-8031
Practice Address - Street 1:10450 NEW HAVEN RD
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-2780
Practice Address - Country:US
Practice Address - Phone:513-981-5852
Practice Address - Fax:513-367-8031
Is Sole Proprietor?:No
Enumeration Date:2021-02-24
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.313799163W00000X
OHAPRN.CNP.0028572363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner