Individual provider · Type 1 NPI
Leisa Dettloff
Family Nurse Practitioner · Troy, MI
NPI number
1972156818
Active
Practice location
44201 Dequindre Rd
Troy, MI 48085-1117
Mailing address
14214 Moravian Manor Cir
Sterling Heights, MI 48312-5796
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 4704292580 (MI) |
Family Nurse Practitioner: Definition to come...
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About NPI 1972156818
Leisa Dettloff's National Provider Identifier is 1972156818, issued on Jul 19, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Troy, MI. The record was last updated on Jul 15, 2022.