Provider Demographics
NPI:1457605503
Name:HART, LISA RACHELLE
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:RACHELLE
Last Name:HART
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 1:847 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4680
Mailing Address - Country:US
Mailing Address - Phone:614-390-8552
Mailing Address - Fax:
Practice Address - Street 1:847 4TH ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-4680
Practice Address - Country:US
Practice Address - Phone:614-390-8552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-27
Last Update Date:2012-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No376J00000XNursing Service Related ProvidersHomemaker