Individual
MS. LISA CAMILLE ROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2689
(313) 916-2600
Mailing address
5075 GREAT FOSTERS DR, ROCHESTER, MI 48306-2437
(586) 381-0674
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704307865
MI
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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