Individual
LISA MARIE FETTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704181247
MI
363LA2100X
Acute Care Nurse Practitioner
4704181247
MI
363LF0000X
Family Nurse Practitioner
4704181247
MI
Other
Enumeration date
10/16/2015
Last updated
08/01/2023
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