Provenzano, Lisa

Provenzano, Lisa is an individual health care provider with primary practice located at 359 Enterprise Ct Spc B , Bloomfield Hills MI 48302-1055. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Provenzano, Lisa can be contacted via phone (248) 751-7246.

Contact Information

Primary practice address
359 Enterprise Ct Spc B Bloomfield Hills MI 48302-1055
Phone: (248) 751-7246
Fax: (248) 418-2311
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704150069 Michigan

Profile Details

NPI number 1609051135
LBN Legal business name Provenzano, Lisa
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2008
Last updated May 23rd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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