Individual
LISA GAYLE DUGAN MANOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2805 GILBERT AVE, CINCINNATI, OH 45206-1210
(513) 815-4475
Mailing address
2805 GILBERT AVE, CINCINNATI, OH 45206-1210
(513) 815-4475
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
422891
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
422891
NURSING LICENSE
OH
Enumeration date
04/02/2020
Last updated
04/02/2020
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