Individual
LISA HALTINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
117 W 3RD ST, ROYAL OAK, MI 48067-3831
(248) 965-6605
(615) 468-4583
Mailing address
117 W 3RD ST, ROYAL OAK, MI 48067-3831
(248) 965-6605
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704288440
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780047365
THIRD PARTY INSURANCE
MI
Enumeration date
08/07/2018
Last updated
08/07/2018
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