Provider Demographics
NPI:1225792757
Name:NESLINE, LISA M (APRN FNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:NESLINE
Suffix:
Gender:F
Credentials:APRN FNP
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:M
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:75 ARCH ST STE 301
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1429
Mailing Address - Country:US
Mailing Address - Phone:330-253-1800
Mailing Address - Fax:330-253-3955
Practice Address - Street 1:1949 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-6910
Practice Address - Country:US
Practice Address - Phone:330-867-5410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-31
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029901363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily