LISA PROVENZANO

BLOOMFIELD HILLS, MI
NPI1609051135
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: MI  4704150069)
Enumeration Date2008-01-03
Last Update Date2023-05-23
Business Address
LISA PROVENZANO N.P.
359 ENTERPRISE CT SPC B
BLOOMFIELD HILLS, MI 48302-1055
Phone number: 248-751-7246
Mailing Address
LISA PROVENZANO N.P.
359 ENTERPRISE CT SPC B
BLOOMFIELD HILLS, MI 48302-1055
Phone number: 248-751-7246
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