Lisa Black
Individual provider Active NPI Home Health Aide · Wellston, OH
NPI 1922607696 · NPPES record last updated Oct 22, 2020
Key facts
- NPI
- 1922607696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- Practice address
- 1119 S New York Ave
Wellston, OH 45692-2427 - Phone
- (740) 577-7920
- NPI assigned
- Oct 22, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Yes |
Addresses
Primary practice location
1119 S New York Ave
Wellston, OH 45692-2427
Mailing address
1119 S New York Ave
Wellston, OH 45692-2427
Phone (740) 577-7920
Other providers in Wellston, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.