Provider Demographics
NPI:1003301516
Name:BAINTER, LISA (APRN-NPC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:BAINTER
Suffix:
Gender:F
Credentials:APRN-NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 HUGHES DR STE 760
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-5111
Mailing Address - Country:US
Mailing Address - Phone:419-291-7555
Mailing Address - Fax:419-479-2696
Practice Address - Street 1:2109 HUGHES DR STE 760
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-5111
Practice Address - Country:US
Practice Address - Phone:419-291-7555
Practice Address - Fax:419-479-2696
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14273317363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily