Provider Demographics
NPI:1437454105
Name:HOSCH, LISA A (FNP-BC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:A
Last Name:HOSCH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 DIXIE HWY STE 106
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-1775
Mailing Address - Country:US
Mailing Address - Phone:502-995-7008
Mailing Address - Fax:502-995-7009
Practice Address - Street 1:5120 DIXIE HWY STE 106
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-1775
Practice Address - Country:US
Practice Address - Phone:502-995-7008
Practice Address - Fax:502-995-7009
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28189221A163W00000X
KY1105112163W00000X
KY3006611208D00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP400041550Medicare PIN