Individual
LISA MARIE TETZLAFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
700 NEWBERRY AVE, NEWBERRY, MI 49868-1503
(906) 293-3226
(877) 743-0490
Mailing address
9789 W BAIRD ST, BRIMLEY, MI 49715-9291
(906) 203-6042
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
L1-0037352
DE
363LF0000X
Family Nurse Practitioner
Primary
4704267555
MI
Other
Enumeration date
01/27/2010
Last updated
07/16/2014
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