| Lisa A Gates, RN BSN | |
| 
					3033 Kettering Blvd Ste 100, Moraine, OH 45439  | |
| (937) 293-2133 | |
| (855) 252-2435 | 
| Full Name | Lisa A Gates | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 3033 Kettering Blvd Ste 100, Moraine, Ohio | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1629228929 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 163W00000X | Registered Nurse | RN 207875 (Ohio) | Secondary | 
| 363LF0000X | Nurse Practitioner - Family | APRN.CNP.024014 (Ohio) | Primary | 
| Entity Name | Vpa Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1932386059 PECOS PAC ID: 9234041948 Enrollment ID: O20031119000596  | 
| Entity Name | Signify Health Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1689158487 PECOS PAC ID: 3274895263 Enrollment ID: O20210303002044  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Lisa A Gates, RN BSN 3033 Kettering Blvd Ste 100, Moraine, OH 45439-1948 Ph: (937) 293-2133  | Lisa A Gates, RN BSN 3033 Kettering Blvd Ste 100, Moraine, OH 45439 Ph: (937) 293-2133  | 
Rachel Bird, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5348 Lamme Rd, Moraine, OH 45439 Phone: 937-534-4651  | |
Mrs. Tamara Kay Thorn, CNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 5348 Lamme Rd, Moraine, OH 45439 Phone: 937-534-4600 Fax: 937-522-8799  | |
Christine Ann Zidek, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3033 Kettering Blvd, Ste 100, Moraine, OH 45439 Phone: 937-293-2133 Fax: 937-293-2161  | |
Stefanie Cain, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3033 Kettering Blvd Ste 100, Moraine, OH 45439 Phone: 937-293-2133 Fax: 855-252-2435  | |
Teresa Sue Thorpe, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2912 Springboro Rd West, Suite 201, Moraine, OH 45439 Phone: 937-297-8999  | |
Jane Ruthann Aridge, REGISTERED NURSE Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3095 Kettering Blvd, Moraine, OH 45439 Phone: 937-293-8300  | |
Lori Ann Morgan, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2921 W Alex Bell Rd, Moraine, OH 45459 Phone: 937-991-3601  |