Individual
LYSA GREENIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-6340
Mailing address
6444 HURON ST, TAYLOR, MI 48180-1951
(248) 469-7028
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
4704279379
MI
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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