Individual
MRS. GAIL ANN LIS
Active
Individual
MRS. GAIL ANN LIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN BC
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704132475
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50-0-86-6974-0
BCBSM
MI
Enumeration date
12/27/2006
Last updated
07/08/2007
Update your record
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