Healthcare Provider Details

I. General information

NPI: 1619300795
Provider Name (Legal Business Name): ALLISON LEE LEMAN RN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON LEE FOX RN, FNP-C

II. Dates (important events)

Enumeration Date: 08/13/2013
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 E 12 MILE RD
WARREN MI
48093-3472
US

IV. Provider business mailing address

17717 MASONIC
FRASER MI
48026-3158
US

V. Phone/Fax

Practice location:
  • Phone: 586-573-5059
  • Fax:
Mailing address:
  • Phone: 586-294-0600
  • Fax: 586-294-2525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704265097
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704265097
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: