Provider Demographics
NPI:1194962357
Name:ASHCRAFT-CARR, LISA L (MS, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:L
Last Name:ASHCRAFT-CARR
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:L
Other - Last Name:ASHCRAFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD
Mailing Address - Street 1:3 HOSPITAL PLZ
Mailing Address - Street 2:P.O. BOX 1680
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-9316
Mailing Address - Country:US
Mailing Address - Phone:304-624-2506
Mailing Address - Fax:304-624-2272
Practice Address - Street 1:3 HOSPITAL PLZ
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-9316
Practice Address - Country:US
Practice Address - Phone:304-624-2506
Practice Address - Fax:304-624-2272
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV102133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered