Individual
LISA TARRANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1460 ROBERT BRADBY DR APT A, DETROIT, MI 48207-4930
(313) 289-7456
Mailing address
1460 ROBERT BRADBY DR APT A, DETROIT, MI 48207-4930
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703078859
MI
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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