| Doctor Name: | DR. LISA MARIE WARGO |
| NPI Number: | 1003288226 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DNP |
| License Number: | 4704243582 |
| Business Practice Address: | 27351 Dequindre Rd Madison Heights, MI - 480713487 |
| Business Phone Number: | 2489677000 |
| Business Fax Number: | |
| Mailing Address: | 8655 Lillian Dr, WASHINGTON TOWNSHIP |
| State: | MI |
| Postal Code: | 480943840 |
| Phone Number: | 5863377204 |
| Fax Number: | |
| NPI Enumeration Date: | 10/27/2015 |
| NPI Last Update Date: | 10/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 4704243582 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |