Individual
LISA RENEE BECKWITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-0547
Mailing address
28220 WILDWOOD TRL, FARMINGTON HILLS, MI 48336-2159
(248) 476-6432
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
4704212047
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704212047
MI
Other
Enumeration date
09/10/2011
Last updated
03/29/2021
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