Individual
MS. LISA ANN DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
468 CADIEUX RD, GROSSE POINTE, MI 48230-1507
(313) 473-1605
(313) 473-1934
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1865
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
4704207550
MI
363LA2200X
Adult Health Nurse Practitioner
Primary
4704207550
MI
Other
Enumeration date
07/31/2012
Last updated
07/15/2022
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