Individual
LISA MAYER ERTZBISCHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5301 MCAULEY DR, YPSILANTI, MI 48197-1051
(734) 712-3325
Mailing address
PO BOX 446, ANN ARBOR, MI 48106-0446
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704145345
MI
363LN0000X
Neonatal Nurse Practitioner
Primary
4704145345
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4578813
—
MI
01
—
500F318190
BCBSM
MI
Enumeration date
07/31/2006
Last updated
10/14/2016
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