Healthcare Provider Details

I. General information

NPI: 1740598838
Provider Name (Legal Business Name): LISA ANN RHINEHART LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

374 RIDGEWOOD DR
FAIRBORN OH
45324-4044
US

IV. Provider business mailing address

374 RIDGEWOOD DR
FAIRBORN OH
45324-4044
US

V. Phone/Fax

Practice location:
  • Phone: 937-312-5854
  • Fax:
Mailing address:
  • Phone: 937-312-5854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number132063
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: