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NPI Code Detail

MEDICARE: LISA WIMBERLY NP

MEDICARE: LISA WIMBERLY NP
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
1363LF0000XFamily Nurse Practitioner08232OH

General Provider Information

NPI Number : 1700962057
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA WIMBERLY NP
Provider Business Mailing Address
First Line : 4961 ROBERTS RD
Second Line :
City : HILLIARD
State : OH
Zip : 43026-8129
Country : US
Telephone Number : 800-389-2727
Fax Number :
Provider Business Practice Location Address
First Line : 4961 ROBERTS RD
Second Line :
City : HILLIARD
State : OH
Zip : 43026-8129
Country : US
Telephone Number : 800-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2006
Last Update Date : 07/27/2012

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