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NPI Code Detail

MEDICARE: MRS. LISA MARGARET SHAFT

MEDICARE: MRS. LISA MARGARET SHAFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse4704244227MI
2367500000XCertified Registered Nurse Anesthetist4704244227MI

General Provider Information

NPI Number : 1093941536
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA MARGARET SHAFT
Provider Business Mailing Address
First Line : 36745 WEST FIVE MILE ROAD
Second Line :
City : LIVONIA
State : MI
Zip : 48154-7502
Country : US
Telephone Number : 734-655-2031
Fax Number :
Provider Business Practice Location Address
First Line : 2215 FULLER RD
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-2303
Country : US
Telephone Number : 734-769-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2009
Last Update Date : 04/06/2026

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Directions to “ MRS. LISA MARGARET SHAFT ” Practice Location

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