Individual provider Active NPI

Lisa Marbury, LPN

  • Licensed Practical Nurse
  • Ann Arbor, MI
National Provider Identifier
1376334284
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703121836 Issued in MI
Practice address
3200 E Eisenhower Pkwy
Ann Arbor, MI 48108-3231
Phone
(734) 677-0070
NPI assigned
May 13, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703121836 MI Primary

Addresses

Primary practice location

3200 E Eisenhower Pkwy
Ann Arbor, MI 48108-3231

Mailing address

105 Russell CT
Ypsilanti, MI 48198-5959
Phone (734) 677-0070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4703121836MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1376334284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RUSSELL CT",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985959",
            "telephone_number": "734-677-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 E EISENHOWER PKWY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083231",
            "telephone_number": "734-677-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARBURY",
        "first_name": "LISA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703121836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.