Individual
MRS. LIZA JENNIFER WHITACRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
7443 JACKMAN RD, TEMPERANCE, MI 48182
(734) 850-0112
(734) 850-0100
Mailing address
6009 MITCHAW RD, SYLVANIA, OH 43560-9410
(419) 494-6638
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4704345718
MI
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.02265
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MI
05
—
PENDING
—
OH
Enumeration date
06/19/2018
Last updated
08/08/2018
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