Lisa Provenzano in Bloomfield Hills - Nurse Practitioner
Lisa Provenzano - NPI 1609051135
Lisa Provenzano is a Nurse Practitioner in Bloomfield Hills, Michigan. Lisa Provenzano practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Lisa Provenzano is 1609051135. The last update date is 2023-05-23.
Lisa Provenzano's current location address is 359 Enterprise Ct Spc B, Bloomfield Hills, Michigan. You can contact this provider via phone number 2487517246 and fax number 2484182311. The mailing address for Lisa Provenzano is 359 Enterprise Ct Spc B, Bloomfield Hills, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Lisa Provenzano |
|---|---|
| Address | 359 Enterprise Ct Spc B, Bloomfield Hills, Michigan |
| Phone Number | 2487517246 |
| Fax Number | 2484182311 |
| Sole Proprietor | N |
| Credentials | N.P. |
NPI Number Detail
| NPI Number | 1609051135 |
|---|---|
| Provider Enumeration Date | 2008-01-03 |
| Last Updated Date | 2023-05-23 |
Provider Mailing Address Detail
| Address | 359 Enterprise Ct Spc B |
|---|---|
| City | Bloomfield Hills |
| State | Michigan (MI) |
| Post Code | 483021055 |
| Phone Number | 2487517246 |
| Fax Number | 2484182311 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
| Licence No | 4704150069 |
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Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
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What is the unique 10-digit identifier code assigned to Lisa Provenzano by the Centers for Medicare & Medicaid Services?
The Lisa Provenzano has been issued the NPI (National Provider Identifier) 1609051135 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Lisa Provenzano?
The Lisa Provenzano is physically situated at 359 Enterprise Ct Spc B, in the city of Bloomfield Hills, state of MI, with the postal code 483021055.
What is Lisa Provenzano's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Lisa Provenzano's specialized field of practice is Nurse Practitioner, and the corresponding taxonomy code that categorizes this area of specialization is 363L00000X.
On what date did the Lisa Provenzano receive its 1609051135 assignment from the Centers for Medicare & Medicaid Services?
The Lisa Provenzano was assigned its 1609051135 by the Centers for Medicare & Medicaid Services on 2008-01-03.
As of what date were the Lisa Provenzano's details last updated?
The information pertaining to the Lisa Provenzano, including its address, specialty, and other details, was most recently updated on 2023-05-23.