Provider Demographics
NPI:1922172923
Name:MCHONE, LISA A (NP, RN)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:MCHONE
Suffix:
Gender:F
Credentials:NP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 17TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-5417
Mailing Address - Country:US
Mailing Address - Phone:812-314-8059
Mailing Address - Fax:812-314-8154
Practice Address - Street 1:2626 17TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-5417
Practice Address - Country:US
Practice Address - Phone:812-314-8059
Practice Address - Fax:812-314-8154
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28078651A163W00000X
IN71000611A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse