Provider Demographics
NPI:1922803923
Name:SHAHEEN, LISA (NP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SHAHEEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6665 GROVE LN
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44134-6962
Mailing Address - Country:US
Mailing Address - Phone:216-444-9819
Mailing Address - Fax:
Practice Address - Street 1:6665 GROVE LN
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44134-6962
Practice Address - Country:US
Practice Address - Phone:216-444-9819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN253618390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program