Individual
LISA MARIE MCNICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 S 3RD ST APT 714, MARTINS FERRY, OH 43935-1473
(614) 398-8419
Mailing address
100 S 3RD ST APT 714, MARTINS FERRY, OH 43935-1473
(614) 398-8419
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125553494
—
WV
05
—
1356607394
—
WV
05
—
1821206228
—
WV
Enumeration date
12/28/2023
Last updated
12/28/2023
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