Provider Demographics
NPI:1538495379
Name:WRIGHT, LISA DIONNE (PN)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:DIONNE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 JOFFRE AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43607-1616
Mailing Address - Country:US
Mailing Address - Phone:419-386-5477
Mailing Address - Fax:
Practice Address - Street 1:1920 JOFFRE AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-1616
Practice Address - Country:US
Practice Address - Phone:419-386-5477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH136878164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse