Provider Demographics
NPI:1275760258
Name:SCHAEFFER, LISA SUE (STNA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:SUE
Last Name:SCHAEFFER
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:SUE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:STNA
Mailing Address - Street 1:592 MOSS HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8368
Mailing Address - Country:US
Mailing Address - Phone:740-663-4628
Mailing Address - Fax:
Practice Address - Street 1:592 MOSS HOLLOW RD
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8368
Practice Address - Country:US
Practice Address - Phone:740-663-4628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH501093840406376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide