Individual
LISA LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
43201 COMMONS DR, CLINTON TWP, MI 48038-1110
(586) 228-0780
Mailing address
57517 APPLE CREEK DR, WASHINGTON, MI 48094-3228
(586) 909-8562
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704176591
MI
Other
Enumeration date
04/02/2012
Last updated
04/02/2012
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