Individual
LISA MCINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
15600 19 MILE RD, CLINTON TOWNSHIP, MI 48038-3502
(586) 925-3566
Mailing address
15600 19 MILE RD, CLINTON TOWNSHIP, MI 48038-3502
(586) 925-3566
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
4704202207
MI
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/06/2020
Last updated
03/06/2020
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