DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: LISA OMO-GRIFFITH N.P.

MEDICARE: LISA OMO-GRIFFITH N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse28156677IN
2363LF0000XFamily Nurse PractitionerCOA13460OH
3363LF0000XFamily Nurse Practitioner71003136IN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P01044179OTHERINR.R. MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000682872OTHERINANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629399696
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA OMO-GRIFFITH N.P.
Provider Business Mailing Address
First Line : 6809 COVINGTON CREEK TRL
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-2871
Country : US
Telephone Number : 260-437-4173
Fax Number : 260-918-6855
Provider Business Practice Location Address
First Line : 5646 COVENTRY LN
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-7140
Country : US
Telephone Number : 260-203-5441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2010
Last Update Date : 09/11/2023

Similar Medicare Providers

1316928195 — DR. JEFFREY WALTER SASSMANNSHAUSEN M.D.
Practice Location Address:
5650 COVENTRY LN
FORT WAYNE, IN
46804-7140
Practice Phone: 260-436-9696
Practice Fax: 888-370-2203
1750390902 — A. MICHELLE FERGUSON PA-C
Practice Location Address:
5650 COVENTRY LN
FORT WAYNE, IN
46804-7140
Practice Phone: 260-436-9696
Practice Fax: 888-370-2203
1992991475 — THREE RIVERS DERMATOLOGY, LLC
Practice Location Address:
5650 COVENTRY LN
FORT WAYNE, IN
46804-7140
Practice Phone: 260-436-9696
Practice Fax: 260-436-9424
1073963351 — MISS JENIFER KAY FORTNEY PA-C
Practice Location Address:
5650 COVENTRY LN
FORT WAYNE, IN
46804-7140
Practice Phone: 217-508-8478
Practice Fax:
1396248415 — MS. JACQUELYN RAY BEEMER PA-C
Practice Location Address:
5650 COVENTRY LN
FORT WAYNE, IN
46804-7140
Practice Phone: 260-436-9696
Practice Fax:
1740905488 — DANA LINGEL PA-C
Practice Location Address:
5650 COVENTRY LN
FORT WAYNE, IN
46804-7140
Practice Phone: 260-436-9696
Practice Fax:

Directions to “ LISA OMO-GRIFFITH N.P.” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.