MEDICARE: MRS. LISA MICHELLE BYRD ANP-BC

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
1	363LA2200X	Adult Health Nurse Practitioner	13785-NP	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13785-EX1	OTHER	OH	PRESCRIPTIVE EXTERNSHIP
2	335810	OTHER	OH	OHIO RN
3	13785-NP	OTHER	OH	ADVANCED PRACTICE CERTIFICATE OF AUTHORITY

General Provider Information

NPI Number	:	1912258963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA MICHELLE BYRD ANP-BC

Provider Business Mailing Address
First Line	:	8240 NORTHCREEK DR STE 2000
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-0709
Country	:	US
Telephone Number	:	513-481-3400
Fax Number	:

Provider Business Practice Location Address
First Line	:	8240 NORTHCREEK DR STE 2000
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-0709
Country	:	US
Telephone Number	:	513-481-3400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2012
Last Update Date	:	01/05/2026

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