Provider Demographics
NPI:1023479664
Name:VONRISSEN, LISA (ACNP-BC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:VONRISSEN
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:BRENTLINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5969 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1546
Mailing Address - Country:US
Mailing Address - Phone:513-515-5363
Mailing Address - Fax:
Practice Address - Street 1:5969 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1546
Practice Address - Country:US
Practice Address - Phone:513-515-5363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2015011219363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care