Individual
LISA NEEB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1122 TUPPER LAKE ST, LAKE ODESSA, MI 48849-1162
(616) 755-0938
(616) 374-1067
Mailing address
1122 TUPPER LAKE ST, LAKE ODESSA, MI 48849-1162
(616) 755-0938
(616) 374-1067
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
4703094902
MI
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
07/06/2015
Last updated
07/06/2015
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