MRS. GAIL ANN LIS APRN BC NPI 1639235682

NPI Information

NPI: 1639235682
Provider Name: MRS. GAIL ANN LIS, APRN BC
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
16010 19 MILE RD
SUITE 101
CLINTON TWP, MI
ZIP 48038
Phone: (586) 286-8674
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MRS. Gail Ann Lis, APRN BC is an acute care nurse practitioner in Clinton Twp, MI. MRS. Gail Ann Lis, APRN BC NPI is 1639235682. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

16010 19 MILE RD
SUITE 101
CLINTON TWP, MI
ZIP 48038-141
Phone: (586) 286-8674
Fax: (586) 286-5564

The NPI 1639235682 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 12/27/2006 and was last updated on 7/8/2007.

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
1	363LA2100X	Nurse Practitioner	Acute Care	4704132475	MICHIGAN	Yes

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
1	50-0-86-6974-0	OTHER	MICHIGAN	BCBSM
2	0N64240	MEDICARE ID-TYPE UNSPECIFIED	MICHIGAN

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: 5/5/2024

NPI Synchronization or Removal

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