Lisa L Spence, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704270877 Issued in MI

Practice address

324 5TH St
Calumet, MI 49913-1502

Phone

(906) 337-3436

NPI assigned

Aug 12, 2009

Last updated

Aug 12, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250035200000",
    "number": "1245462142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 5TH ST",
            "city": "CALUMET",
            "state": "MI",
            "postal_code": "499131502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 5TH ST",
            "city": "CALUMET",
            "state": "MI",
            "postal_code": "499131502",
            "telephone_number": "906-337-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "LISA",
        "middle_name": "L",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-12",
        "last_updated": "2009-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704270877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Serice Rutherford
• Ryan Anthony Salani
• Seals Tacia & Bartz OD PC (InSight EyeCare)
• Robert William Sharkey, PH.D.
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 2606)
• Cali St George
• Superior Caregivers, Inc.
• Superior Pediatrics, PLLC
• Ashley Taskila
• Upper Great Lakes Family Health Center (Calumet Family Health Center)

• Pediatric Nurse Practitioner in Calumet, MI
• Providers in Calumet, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.