Provider Demographics
NPI:1780621011
Name:MCCURRY, LISA M (CRNA)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:MCCURRY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37800 FLANDERS DR
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-6714
Mailing Address - Country:US
Mailing Address - Phone:440-248-0013
Mailing Address - Fax:
Practice Address - Street 1:37800 FLANDERS DR
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-6714
Practice Address - Country:US
Practice Address - Phone:440-248-0013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-3480700367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8246161OtherMEDICARE PROVIDER NUMBER
OH2975179OtherMEDICAID PROVIDER NUMBER