Individual
MS. LISA T NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., PA-C
Contact information
Practice address
13322 CONANT ST, DETROIT, MI 48212-2338
(313) 366-9050
(313) 366-3809
Mailing address
34811 MELTON ST, WESTLAND, MI 48186-4469
(734) 728-9532
(734) 728-9532
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601002707
MI
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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