Provider Demographics
NPI:1588005946
Name:CASCARELLI, LISA J (ACNP-BC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:CASCARELLI
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:J
Other - Last Name:PARISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNP-BC
Mailing Address - Street 1:1001 COVINGTON ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44510-1617
Mailing Address - Country:US
Mailing Address - Phone:330-480-2371
Mailing Address - Fax:330-480-3970
Practice Address - Street 1:1001 COVINGTON ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44510
Practice Address - Country:US
Practice Address - Phone:330-480-2371
Practice Address - Fax:330-480-3970
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.174989-COA1163W00000X
OHAPRN.CNP.14707363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0113843Medicaid