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Individual

MS. LISA D MICHAUX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, BC

Contact information

Practice address
31815 SOUTHFIELD RD, STE 22, BEVERLY HILLS, MI 48025-5471
(248) 594-3142
(248) 594-3249
Mailing address
31815 SOUTHFIELD RD, STE 22, BEVERLY HILLS, MI 48025-5471
(248) 594-3142
(248) 594-3249

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704232028
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08669640
BCBSM
MI
01
453943
VALUE OPTIONS
MI
01
G42072
HAP
MI
Enumeration date
07/19/2006
Last updated
06/19/2013
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