Individual
LISA KAY ASTALOS CHISM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S, R.N., C.S.
Contact information
Practice address
21090 ALLEN RD, WOODHAVEN, MI 48183-1602
(734) 676-9800
(734) 676-9801
Mailing address
23401 LEIGHWOOD DR, WOODHAVEN, MI 48183-2774
(734) 676-9800
(734) 676-9801
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704176901
MI
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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