Provider Demographics
NPI:1376125575
Name:BOUND, LISAMARIE (LPN)
Entity Type:Individual
Prefix:
First Name:LISAMARIE
Middle Name:
Last Name:BOUND
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:LISAMARIE
Other - Middle Name:
Other - Last Name:SCLIMENTI BOUND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:13912 CHAPELSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-4620
Mailing Address - Country:US
Mailing Address - Phone:216-392-2217
Mailing Address - Fax:
Practice Address - Street 1:8101 EUCLID AVE STE 21
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-5059
Practice Address - Country:US
Practice Address - Phone:216-220-0035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH122951164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse