Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 2015011219 | OH |
NPI | 1023479664 |
---|---|
Provider Name | Lisa Vonrissen |
First Address | Columbus, OH 43213-1546 |
Second Address | Columbus, OH 43213-1546 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2016 |
Last Update Date | 09/03/2016 |