Provider Demographics
NPI:1447531959
Name:VARNEY, LISA GAY (LPN)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:GAY
Last Name:VARNEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 PONDEROSA AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OH
Mailing Address - Zip Code:44903-8237
Mailing Address - Country:US
Mailing Address - Phone:440-309-6936
Mailing Address - Fax:
Practice Address - Street 1:3175 PONDEROSA AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44903-8237
Practice Address - Country:US
Practice Address - Phone:440-309-6936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN131311164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse