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Individual

MRS. LISA A. MOGHISSI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
3535 OLENTANGY RIVER RD, RIVERSIDE METHODIST HOSPITAL, COLUMBUS, OH 43214
(614) 566-5366
(614) 566-6675
Mailing address
700 CHILDRENS DRIVE, J4 NICU - NNP PROGRAM, COLUMBUS, OH 43205
(614) 722-6510
(722) 722-4772

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN308941-COA1
OH
363L00000X
Nurse Practitioner
Primary
COA07617
OH
363LN0005X
Critical Care Neonatal Nurse Practitioner
NCCMOGI-0427-7877
OH

Other

Enumeration date
01/09/2009
Last updated
01/09/2009
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