Provider Demographics
NPI:1023008232
Name:STANKEN, LISA F (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:F
Last Name:STANKEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:935 STATE ROUTE 28
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1957
Mailing Address - Country:US
Mailing Address - Phone:513-831-5955
Mailing Address - Fax:513-831-8685
Practice Address - Street 1:4440 RED BANK RD STE 110
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-2177
Practice Address - Country:US
Practice Address - Phone:513-564-1366
Practice Address - Fax:513-564-1367
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2020-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY35900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYH17547Medicare UPIN
KY0919004Medicare ID - Type Unspecified