Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lisa Rae Innis, PA-C

Individual provider Physician Assistant · NPI 1922192350

Lisa Rae Innis, PA-C is a Physician Assistant in Beavercreek, Ohio. Licensed in California and Ohio. Registered with an NPI since 2006.

Licensed in
CA, OH
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

75 Sylvania Dr
Beavercreek, OH 45440-3237
Phone: (937) 320-5050
Fax: (937) 320-5060
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.001303RX (OH)
Physician Assistant Taxonomy 363A00000X · Licence PA17447 (CA)

Record details

NPI number1922192350
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 2, 2006
Last updated in NPPESAugust 24, 2020
Certification dateAugust 24, 2020

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