Individual
LISA MAE JUSTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
41641 N RIDGE RD, ELYRIA, OH 44035-1264
(440) 324-7406
Mailing address
36237 WESTFIELD DR, NORTH RIDGEVILLE, OH 44039-3839
(440) 865-4804
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
RN.447510
OH
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN.447510
OH
Other
Enumeration date
03/20/2019
Last updated
03/20/2019
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