MEDICARE: LISA A STULL PA

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
1	363A00000X	Physician Assistant	0110002427	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396827994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA A STULL PA

Provider Business Mailing Address
First Line	:	4600 MONTGOMERY RD STE 400
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45212-2600
Country	:	US
Telephone Number	:	513-873-1269
Fax Number	:

Provider Business Practice Location Address
First Line	:	1836 VIRGINIA AVE
Second Line	:
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-8490
Country	:	US
Telephone Number	:	833-510-4357
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	01/06/2025

Similar Medicare Providers

1841753886 — ARIEL LEE JOHNSON LCSW
Practice Location Address:

1856 VIRGINIA AVE
MARTINSVILLE, VA
24112-8490

Practice Phone: 276-224-7400
Practice Fax:

1063132264 — LISA M SMITH
Practice Location Address:

1836 VIRGINIA AVE
MARTINSVILLE, VA
24112-8490

Practice Phone: 419-580-1305
Practice Fax:

1700583812 — AMBER NICOLE TREADWAY
Practice Location Address:

1836 VIRGINIA AVE
MARTINSVILLE, VA
24112-8490

Practice Phone: 833-510-4357
Practice Fax: 866-460-2997

1427737477 — SACHA CAUGHORN LPC, CSAC
Practice Location Address:

1836 VIRGINIA AVE
MARTINSVILLE, VA
24112-8490

Practice Phone: 833-510-4357
Practice Fax:

1730827981 — MR. CAMERON GLENN BRUMMITT DPT
Practice Location Address:

94 COLLEGE DRIVE
MARTINSVILLE, VA
24112

Practice Phone: 276-252-6001
Practice Fax:

1710815519 — MARCKISHA MARTIN LPC
Practice Location Address:

24 CLAY ST
MARTINSVILLE, VA
24112-2810

Practice Phone: 276-632-7128
Practice Fax: 276-632-0127

Directions to “ LISA A STULL PA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.