Provider Demographics
NPI:1841403839
Name:SCHLOSSER, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SCHLOSSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 CHIMNEY LN
Mailing Address - Street 2:APT 2D
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45440
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1980 CHIMNEY LN
Practice Address - Street 2:APT 2D
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45440
Practice Address - Country:US
Practice Address - Phone:937-271-7874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2710249Medicaid