Provider Demographics
NPI:1245983337
Name:ALLEN-CAMPBELL, LISA HANNAH
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:HANNAH
Last Name:ALLEN-CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 HIDDEN LAKE CT
Mailing Address - Street 2:
Mailing Address - City:FISHERVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40023-9786
Mailing Address - Country:US
Mailing Address - Phone:502-619-1417
Mailing Address - Fax:
Practice Address - Street 1:THE SPRINGS AT LAFAYETTE
Practice Address - Street 2:2402 SOUTH STREET
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904
Practice Address - Country:US
Practice Address - Phone:765-340-8125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1082718163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse