Healthcare Provider Details

I. General information

NPI: 1013820554
Provider Name (Legal Business Name): LISA MCCARTIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1483 PEARL RD
BRUNSWICK OH
44212-3416
US

IV. Provider business mailing address

1483 PEARL RD
BRUNSWICK OH
44212-3416
US

V. Phone/Fax

Practice location:
  • Phone: 330-273-0500
  • Fax:
Mailing address:
  • Phone: 330-273-0500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN297731
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: