Provider Demographics
NPI:1386286821
Name:LISI, HAYLEY J (CNP)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:J
Last Name:LISI
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:J
Other - Last Name:CROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:655 AFRICA RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9808
Mailing Address - Country:US
Mailing Address - Phone:614-326-2672
Mailing Address - Fax:614-326-3293
Practice Address - Street 1:655 AFRICA RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-9808
Practice Address - Country:US
Practice Address - Phone:614-326-2672
Practice Address - Fax:614-326-3293
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-16
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025665363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner