Healthcare Provider Details

I. General information

NPI: 1417250267
Provider Name (Legal Business Name): LISA CAROL PAXTON MSN, CNP,FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2010
Last Update Date: 01/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE., ML 2010 CINCINNATI CHILDREN'S HOSITAL
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE., ML 2010 CINCINNATI CHILDREN'S HOSITAL
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4415
  • Fax: 513-636-7805
Mailing address:
  • Phone: 513-636-4415
  • Fax: 513-636-7805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.11713-NP
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.11713
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: