| Doctor Name: | LISA MARIE TETZLAFF |
| NPI Number: | 1174854400 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-C |
| License Number: | L1-0037352 |
| Business Practice Address: | 700 Newberry Ave Newberry, MI - 498681503 |
| Business Phone Number: | 9062933226 |
| Business Fax Number: | 8777430490 |
| Mailing Address: | 9789 W Baird St, BRIMLEY |
| State: | MI |
| Postal Code: | 497159291 |
| Phone Number: | 9062036042 |
| Fax Number: | |
| NPI Enumeration Date: | 01/27/2010 |
| NPI Last Update Date: | 07/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | L1-0037352 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | DE |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |