Provider Demographics
NPI:1477323681
Name:ASHBY, LISA (LPN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ASHBY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:CULP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:756 WEST ST
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-1669
Mailing Address - Country:US
Mailing Address - Phone:330-242-1862
Mailing Address - Fax:
Practice Address - Street 1:756 WEST ST
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-1669
Practice Address - Country:US
Practice Address - Phone:330-242-1862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.092607.MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse