Healthcare Provider Details

I. General information

NPI: 1457662538
Provider Name (Legal Business Name): LISA KAYE SEGER RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5573 OLD BLUE ROCK RD
CINCINNATI OH
45247-2771
US

IV. Provider business mailing address

5573 OLD BLUE ROCK RD
CINCINNATI OH
45247-2771
US

V. Phone/Fax

Practice location:
  • Phone: 513-919-2061
  • Fax:
Mailing address:
  • Phone: 513-919-2061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number336837
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: