Provider Demographics
NPI:1427755107
Name:HOWARD, LISA R
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:R
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2914 LOWER TWIN RD
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45123-8220
Mailing Address - Country:US
Mailing Address - Phone:937-403-6091
Mailing Address - Fax:
Practice Address - Street 1:2914 LOWER TWIN RD
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:OH
Practice Address - Zip Code:45123-8220
Practice Address - Country:US
Practice Address - Phone:937-403-6091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNONEOtherNONE
OH1427755107Medicaid