Provider Demographics
NPI:1447803135
Name:LEININGER, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:LEININGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4780 STATE ROUTE 73
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-9011
Mailing Address - Country:US
Mailing Address - Phone:937-393-1779
Mailing Address - Fax:
Practice Address - Street 1:4780 STATE ROUTE 73
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-9011
Practice Address - Country:US
Practice Address - Phone:937-393-1779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator