Individual
LISA STUART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
1510 11TH ST, WYANDOTTE, MI 48192-3354
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
4704198666
MI
Other
Enumeration date
09/26/2025
Last updated
09/26/2025
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