Individual provider · Type 1 NPI
Jenaye Laron Lisbon, FNP
Primary Care Nurse Practitioner · Detroit, MI
NPI number
1265980023
Active
Practice location
7700 Second Avenue, Wellness Plan
Detroit, MI 48202
Mailing address
7442 Rutherford St
Detroit, MI 48228-3652
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | 4704238010 (MI) |
| Family Nurse Practitioner | 363LF0000X | 4704238010 (MI) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1265980023
Jenaye Laron Lisbon, FNP's National Provider Identifier is 1265980023, issued on Sep 21, 2016. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Detroit, MI. The record was last updated on Jun 11, 2018.