Individual
LEA MISKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
103 W US HIGHWAY 2, WAKEFIELD, MI 49968-9515
(906) 229-6166
Mailing address
103 W US HIGHWAY 2, WAKEFIELD, MI 49968-9515
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704263538
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704263538
MI REGISTERED NURSING LICENSE
MI
Enumeration date
07/23/2013
Last updated
07/23/2013
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