Individual
LISA MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
500 CAMPUS DR, HANCOCK, MI 49930-1569
(906) 483-1000
Mailing address
500 CAMPUS DR, HANCOCK, MI 49930-1569
(906) 483-1000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704233949
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0829560001
MEDICARE DME
MI
01
—
LM233949
BLUE CROSS STATE ID
MI
Enumeration date
08/15/2006
Last updated
06/03/2009
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