Provider Demographics
NPI:1902022312
Name:PARDI, LISA A (CNP, MSN, RN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:PARDI
Suffix:
Gender:F
Credentials:CNP, MSN, RN
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:A
Other - Last Name:ARCHUAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1118 RAMBLING WAY
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2172
Mailing Address - Country:US
Mailing Address - Phone:330-666-9350
Mailing Address - Fax:
Practice Address - Street 1:1 PERKINS SQ
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308-1063
Practice Address - Country:US
Practice Address - Phone:330-543-8942
Practice Address - Fax:330-543-3302
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-202528363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2113046Medicaid