Individual
STACY JANELLE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
168 S HOWELL ST, HILLSDALE, MI 49242-2040
(517) 320-6103
Mailing address
4075 COPPER RIDGE DR, TRAVERSE CITY, MI 49684-7059
(517) 320-6103
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704272765
MI
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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