Individual
LISA LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1414 W FAIR AVE STE 35, MARQUETTE, MI 49855-2675
(906) 449-1140
(906) 449-1844
Mailing address
1414 W FAIR AVE STE 35, MARQUETTE, MI 49855-2675
(906) 449-1140
(906) 449-1844
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017003713
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003349937
—
MO
Enumeration date
04/07/2017
Last updated
03/06/2020
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