Jalissa Marie Sutliff
Individual provider Active NPI Personal Care Attendant · Lennon, MI
NPI 1477057248 · NPPES record last updated Mar 19, 2018
Key facts
- NPI
- 1477057248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 11410 E Lennon Rd
Lennon, MI 48449-9666 - Phone
- (810) 621-4721
- NPI assigned
- Mar 19, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Labaza Eyecare, P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
11410 E Lennon Rd
Lennon, MI 48449-9666
Mailing address
715 Division Rd
Owosso, MI 48867-3915
Other providers in Lennon, MI
- Jason Kirk Sailor
- Lilly Rose Sawvel
- Gabrielle Lynn Smith
- Jennifer Ann Steck
- Kayser Michael Steck
- Angyl Marie Taber
- Kellen Taylor
- Logan Matthew Taylor
- Susan Ann Taylor
- Latonya Shante Thomas
All providers in Lennon, MI · Personal Care Attendant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.