Healthcare Provider Details

I. General information

NPI: 1922736255
Provider Name (Legal Business Name): LISA M KERRIGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2022
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2157 GLENWOOD AVE
TOLEDO OH
43620-1511
US

IV. Provider business mailing address

2157 GLENWOOD AVE
TOLEDO OH
43620-1511
US

V. Phone/Fax

Practice location:
  • Phone: 419-242-1997
  • Fax:
Mailing address:
  • Phone: 419-242-1997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: