Provider Demographics
NPI:1316110372
Name:JEANNETTE, LISA (RN BSN)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:JEANNETTE
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 DENNING WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH VERSAILLES
Mailing Address - State:PA
Mailing Address - Zip Code:15137
Mailing Address - Country:US
Mailing Address - Phone:412-824-2151
Mailing Address - Fax:
Practice Address - Street 1:3811 O'HARA STREET
Practice Address - Street 2:WPIC
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213
Practice Address - Country:US
Practice Address - Phone:412-246-5234
Practice Address - Fax:412-246-5210
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN228608L163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent