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MRS. GAIL ANN LIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN BC

Contact information

Practice address
16010 19 MILE RD, SUITE 101, CLINTON TWP, MI 48038-1141
(586) 286-8674
(586) 286-5564
Mailing address
48748 DELMONT DR, NOVI, MI 48374-2767
(248) 380-9978

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
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