| Doctor Name: | LISA A FULLER |
| NPI Number: | 1104198316 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | SP011517 |
| Business Practice Address: | 25 Heckel Rd Ohio Valley General Hospital Mc Kees Rocks, PA - 151361651 |
| Business Phone Number: | 4122580920 |
| Business Fax Number: | 4127776532 |
| Mailing Address: | 25 Heckel Rd, Ohio Valley General Hospital MC KEES ROCKS |
| State: | PA |
| Postal Code: | 151361651 |
| Phone Number: | 4127716003 |
| Fax Number: | 4127776532 |
| NPI Enumeration Date: | 02/02/2012 |
| NPI Last Update Date: | 02/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | SP011517 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |