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NPI Code Detail

MEDICARE: MRS. LISA MARIE RONDEAU

MEDICARE:  MRS. LISA MARIE RONDEAU
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
1374U00000XHome Health Aide2206259OH

General Provider Information

NPI Number : 1750340394
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA MARIE RONDEAU
Provider Business Mailing Address
First Line : 4499 SUMMIT RIDGE DR
Second Line :
City : DAYTON
State : OH
Zip : 45424-4478
Country : US
Telephone Number : 937-237-8457
Fax Number :
Provider Business Practice Location Address
First Line : 4499 SUMMIT RIDGE DR
Second Line :
City : DAYTON
State : OH
Zip : 45424-4478
Country : US
Telephone Number : 937-237-8457
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. LISA MARIE RONDEAU ” Practice Location

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