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NPI Code Detail

MEDICARE: LISA MCCUNE RD, LDN

MEDICARE: LISA MCCUNE RD, LDN
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
1133V00000XRegistered DietitianDI00001123DC
2133V00000XRegistered DietitianLD1425NM
3133V00000XRegistered Dietitian1496NE
4133V00000XRegistered Dietitian11741417-4901UT
5133V00000XRegistered Dietitian1067SD
6133V00000XRegistered DietitianDIET.DI.70091684WA
7133V00000XRegistered Dietitian2153TN

General Provider Information

NPI Number : 1881108561
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MCCUNE RD, LDN
Provider Business Mailing Address
First Line : PO BOX 830242
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19182-0242
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1014 VINE ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-1141
Country : US
Telephone Number : 855-699-6937
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2017
Last Update Date : 03/06/2026

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