Individual
MRS. JENAYE LARON LISBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7700 SECOND AVENUE, WELLNESS PLAN, DETROIT, MI 48202
(313) 202-8500
Mailing address
7442 RUTHERFORD ST, DETROIT, MI 48228-3652
(313) 623-1541
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4704238010
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
4704238010
MI
Other
Enumeration date
09/21/2016
Last updated
06/11/2018
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