Individual
LISA A STULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1836 VIRGINIA AVE, MARTINSVILLE, VA 24112-8490
(833) 510-4357
Mailing address
4600 MONTGOMERY RD STE 400, CINCINNATI, OH 45212-2600
(513) 873-1269
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002427
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010340420
—
VA
Enumeration date
10/20/2006
Last updated
01/06/2025
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