Individual
LISA MAKARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1485 M 139, BENTON HARBOR, MI 49022-5711
(269) 934-1611
(269) 927-1326
Mailing address
1485 M 139, BENTON HARBOR, MI 49022-5711
(269) 934-1611
(269) 927-1326
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704305988
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1716175
—
MI
Enumeration date
03/19/2014
Last updated
03/07/2023
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