Individual
MRS. LISA YACOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P-C
Contact information
Practice address
26000 HOOVER RD, SUITE 103, WARREN, MI 48089-1167
(586) 427-1351
Mailing address
38377 MOUNT KISCO DR, STERLING HEIGHTS, MI 48310-3426
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704240796
MI
Other
Enumeration date
11/28/2011
Last updated
11/28/2011
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