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NPI Code Detail

MEDICARE: MRS. LISA L WEBER RN

MEDICARE:  MRS. LISA L WEBER  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WA2000XAdministrator Registered NurseRN.317629OH

General Provider Information

NPI Number : 1336810670
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA L WEBER RN
Provider Business Mailing Address
First Line : PO BOX 751994
Second Line :
City : DAYTON
State : OH
Zip : 45475-1994
Country : US
Telephone Number : 937-499-4043
Fax Number :
Provider Business Practice Location Address
First Line : 2000 FOX RUN RD
Second Line :
City : DAYTON
State : OH
Zip : 45459-3416
Country : US
Telephone Number : 937-499-4043
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2021
Last Update Date : 09/27/2021

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Directions to “ MRS. LISA L WEBER RN” Practice Location

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