Provider Demographics
NPI:1568650786
Name:WOSNAK, LISA ANN
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:ANN
Last Name:WOSNAK
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LISA
Other - Middle Name:ANN
Other - Last Name:MARTINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18471 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-4337
Mailing Address - Country:US
Mailing Address - Phone:440-572-5082
Mailing Address - Fax:
Practice Address - Street 1:18471 MEADOW LN
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-4337
Practice Address - Country:US
Practice Address - Phone:440-572-5082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH280787163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse