Provider Demographics
NPI:1013253707
Name:LEESE, LISA LYNNE (NP)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:LYNNE
Last Name:LEESE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2200 JEFFERSON AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-7102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2815 DUSTIN RD STE C
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3497
Practice Address - Country:US
Practice Address - Phone:419-691-5716
Practice Address - Fax:419-691-3340
Is Sole Proprietor?:No
Enumeration Date:2012-12-27
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.14008363LW0102X
OHCOA 14008 NP364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health