Individual
LISA SHELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
2213 CHERRY ST, TOLEDO, OH 43608-2603
(491) 251-4283
Mailing address
2222 CHERRY ST STE 1900, TOLEDO, OH 43608-2673
(419) 251-3878
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
APRN.CNP.03100
OH
363LN0005X
Critical Care Neonatal Nurse Practitioner
APRN.CNP.03100
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0122109
—
OH
Enumeration date
02/12/2015
Last updated
04/14/2025
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