Individual
LISA SONIA MACLELLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3250 WOODS WAY STE 5, PETOSKEY, MI 49770-7628
(231) 881-9700
(231) 881-9698
Mailing address
5200 W BEEMAN RD, EMPIRE, MI 49630-9739
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704242836
MI
Other
Enumeration date
06/10/2019
Last updated
08/27/2019
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