LISA A EVANS-THOMAS NP NPI 1609951904

NPI Information

  • NPI: 1609951904
  • Provider Name: LISA A EVANS-THOMAS, NP
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 20952 E 12 MILE RD
    SUITE 200
    SAINT CLAIR SHORES, MI
    ZIP 48081
  • Phone: (586) 771-4820

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NPI Details

Lisa A Evans-thomas, NP is an adult health nurse practitioner in Saint Clair Shores, MI with 21 years of experience. Lisa A Evans-thomas, NP NPI is 1609951904. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2005

The provider's business location address is:

20952 E 12 MILE RD
SUITE 200
SAINT CLAIR SHORES, MI
ZIP 48081-200
Phone: (586) 771-4820
Fax: (586) 771-6620

The NPI 1609951904 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/26/2006 and was last updated on 6/26/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult Health4704130480MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CB9133OTHERMICHIGANMEDICARE RAILROAD
20P12960MEDICARE PINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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