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Individual

MS. LISA LAVONNE KEARNS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN APRN BC

Contact information

Practice address
500 BURLINGTON RD STE 240, JACKSON, OH 45640-9360
(740) 286-5075
(740) 395-8411
Mailing address
PO BOX 188, CHILLICOTHE, OH 45601-0188
(740) 773-4366
(740) 775-7855

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
55208
WV
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
COA.07488-NS
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005355002
WV
05
0200820
OH
05
2476913
OH
Enumeration date
02/28/2006
Last updated
11/06/2019
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