Blackburn, Lisa M

Blackburn, Lisa M is an individual health care provider with primary practice located at 300 W 10Th Ave , Columbus OH 43210-1280. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist, which is considered as her primary health care specialty. Blackburn, Lisa M can be contacted via phone (614) 425-0257.

Contact Information

Primary practice address
300 W 10Th Ave Columbus OH 43210-1280
Phone: (614) 425-0257
Fax: (614) 293-6420
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist 364S00000X NS05202 RN 204106 Ohio

Profile Details

NPI number 1942381660
LBN Legal business name Blackburn, Lisa M
Credentials Clinical Nurse Specialist (CNS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Jan 10th, 2019 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942381660 NPPES
Ohio MEDICAID 2511400

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