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General NPI Number Information
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NPI Number | 1578853354
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Entity Type | Individual
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Provider Name | LISA LORRAINE RITENOUR F.N.P.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 05/10/2013
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Provider Practice Location Address
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Address Line | 4048 DRESSLER RD NW SUITE 100
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City | CANTON
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State | OH
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Zip | 44718-2784
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Country | US
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Telephone | 330-479-3333
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Fax | 330-479-3334
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Provider Business Mailing Address
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Address Line | 4048 DRESSLER RD NW SUITE 100
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City | CANTON
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State | OH
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Zip | 44718-2784
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Country | US
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Telephone | 330-479-3333
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Fax | 330-479-3334
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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 | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number | 12212-NP
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License Number State | OH
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