Black, Lisa A
Black, Lisa A is an sole proprietor health care provider with primary practice located at 1710 Pennsylvania Ave , Charleston WV 25302-3934. She recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as her primary health care specialty. Black, Lisa A can be contacted via phone (304) 348-0707.Contact Information
Primary practice address
1710 Pennsylvania Ave
Charleston WV 25302-3934
Phone: (304) 348-0707
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Related Providers / Personal Care Attendant | 3747P1801X |
Profile Details
| NPI number | 1497461768 |
|---|---|
| LBN Legal business name | Black, Lisa A |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 30th, 2023 |
| Last updated | Jan 30th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497461768 | NPPES |
| West Virginia | MEDICAID | 1982825972 |
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