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NPI Code Detail

MEDICARE: LISA MARIE SHOEMAKER FNP

MEDICARE: LISA MARIE SHOEMAKER FNP
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
1363LF0000XFamily Nurse Practitioner4704248076MI

General Provider Information

NPI Number : 1922621762
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE SHOEMAKER FNP
Provider Business Mailing Address
First Line : 20095 GILBERT RD STE B
Second Line :
City : BIG RAPIDS
State : MI
Zip : 49307-2366
Country : US
Telephone Number : 315-921-3602
Fax Number : 231-592-1361
Provider Business Practice Location Address
First Line : 20095 GILBERT RD STE B
Second Line :
City : BIG RAPIDS
State : MI
Zip : 49307-2366
Country : US
Telephone Number : 315-921-3602
Fax Number : 231-592-1361
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2020
Last Update Date : 04/20/2023

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Directions to “ LISA MARIE SHOEMAKER FNP” Practice Location

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