Individual
MS. LISA SHEPPARD PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
460 W 10TH AVE STE D1900, COLUMBUS, OH 43210-1240
(614) 293-7171
(614) 293-3465
Mailing address
700 ACKERMAN RD STE 570, COLUMBUS, OH 43202-1579
(614) 685-4990
(614) 293-3465
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.167394
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN.CNP.00194
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0253911
—
OH
Enumeration date
06/22/2007
Last updated
01/29/2018
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