Provider Demographics
NPI:1659537868
Name:DENDINGER, LISA E (RN,MSN,NP-C)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:E
Last Name:DENDINGER
Suffix:
Gender:F
Credentials:RN,MSN,NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44871-0378
Mailing Address - Country:US
Mailing Address - Phone:419-609-1112
Mailing Address - Fax:419-609-1123
Practice Address - Street 1:1479 N RIVER RD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-9760
Practice Address - Country:US
Practice Address - Phone:419-355-9440
Practice Address - Fax:419-355-9443
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN161830363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2910710Medicaid
OHDENP27963Medicare PIN