LISA MARIE TOLLIVER PA-C NPI 1043598485

NPI Information

NPI: 1043598485
Provider Name: LISA MARIE TOLLIVER, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
6276 COUNTY ROAD 107
PROCTORVILLE, OH
ZIP 45669
Phone: (888) 221-1826
Get Directions

Lisa Marie Tolliver, PA-C is a medical physician assistant in Proctorville, OH. Lisa Marie Tolliver, PA-C NPI is 1043598485. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6276 COUNTY ROAD 107
PROCTORVILLE, OH
ZIP 45669-867
Phone: (888) 221-1826

The NPI 1043598485 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/3/2011 and was last updated on 11/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	2555	WEST VIRGINIA	No
2	363AM0700X	Physician Assistant	Medical	50.003489	OHIO	No
3	363AM0700X	Physician Assistant	Medical	PA1634	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1043598485	MEDICAID	WEST VIRGINIA
2	P01094323	OTHER	KENTUCKY	RR MEDICARE
3	0166746	MEDICAID	OHIO
4	7100179880	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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