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Individual

LISA C MCCUSKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3130 HIGHLAND AVE, CINCINNATI, OH 45219-2399
(513) 584-4061
(513) 584-3349
Mailing address
5700 GLENVIEW AVE, CINCINNATI, OH 45224-2812
(513) 739-0554
(513) 584-3349

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRNCNP0032787
OH
363LA2200X
Adult Health Nurse Practitioner
LE-00043711
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LE-00043711
CNP NURSING LICENSE
Enumeration date
12/15/2022
Last updated
12/28/2022
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