Doctor Name: | LISA BLAIR |
NPI Number: | 1487031035 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 4703101562 |
Business Practice Address: | 641 Prentis St Apt 112 Detroit, MI - 482013721 |
Business Phone Number: | 7347900711 |
Business Fax Number: | |
Mailing Address: | 641 Prentis St, Apt 112 DETROIT |
State: | MI |
Postal Code: | 482013721 |
Phone Number: | 7347900711 |
Fax Number: | |
NPI Enumeration Date: | 05/04/2015 |
NPI Last Update Date: | 05/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 164W00000X |
License Number: | 4703101562 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Licensed Practical Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |