Individual
LISA MATTUCCI-HUNTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 558-4194
(513) 558-0995
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5502
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.239700-COA1
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
COA.05567-NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200261240
—
IN
05
—
2182089
—
OH
05
—
74006214
—
KY
Enumeration date
08/29/2005
Last updated
06/01/2017
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