Provider Demographics
NPI:1770961740
Name:PATTERSON, LISA D (NP-C)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:D
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:770 BALGREEN DR
Mailing Address - Street 2:FL 1
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-4106
Mailing Address - Country:US
Mailing Address - Phone:419-756-6366
Mailing Address - Fax:419-756-5549
Practice Address - Street 1:375 LEXINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44904
Practice Address - Country:US
Practice Address - Phone:419-520-3500
Practice Address - Fax:419-520-3501
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHCOA.16557-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner