Lisa Ann Dettorre, CPNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

COA.01157-NP Issued in OH

Practice address

701 White Pond Dr Ste 100
Akron, OH 44320-1193

Phone

(330) 865-1252

Fax

(330) 865-1260

NPI assigned

May 2, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Children'S Hospital Medical Center of Akron

  • Home Infusion Agency
  • Akron, OH
  • NPI 1649485848
  NPD (past)
• Children'S Hospital Medical Center of Akron

  • Pediatrics Physician
  • Akron, OH
  • NPI 1841328853
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1780805960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-865-1252",
            "fax_number": "330-865-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 WHITE POND DR STE 100",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443201193",
            "telephone_number": "330-865-1252",
            "fax_number": "330-865-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTORRE",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.01157-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Desmett, M.D.
• Destine Health Care Agency LLC
• Kathleen Sue Detamore, RD, LD
• Haley Erin Dettling, PA-C
• Samuel Drew Dettling, MD
• Elizabeth Ann Detwiler, DO
• Michael John Deutschman, LPN
• Kyle Franklin Devault, DO, PA
• Thomas Clifford Deveny, M.D.
• Grace Alexandra Devine

• Nurse Practitioner in Akron, OH
• Providers in Akron, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.