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General NPI Number Information
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NPI Number | 1013253707
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Entity Type | Individual
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Provider Name | LISA LYNNE LEESE NP
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Gender | Female
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Dates
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Enumeration Date | 12/27/2012
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Last Update Date | 10/12/2024
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Provider Practice Location Address
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Address Line | 2815 DUSTIN RD STE C
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City | OREGON
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State | OH
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Zip | 43616-3497
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Country | US
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Telephone | 419-691-5716
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Fax | 419-691-3340
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Provider Business Mailing Address
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Address Line | 2200 JEFFERSON AVE FL 5
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City | TOLEDO
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State | OH
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Zip | 43604-7102
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | APRN.CNP.14008
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 364SW0102X
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Taxonomy Name | Women's Health Clinical Nurse Specialist
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License Number | COA 14008 NP
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License Number State | OH
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