Lisa Mary Mulder, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

4704371872 Issued in MI

Practice address

901 W Mem Dr
Houghton, MI 49931-2492

Phone

(906) 482-9400

Fax

(906) 483-4866

NPI assigned

Jun 11, 2022

Last updated

Jun 11, 2022By 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

Other names 1

• Lisa Mary Skaggs Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1654905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1508596727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W MEM DR",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499312492",
            "telephone_number": "906-482-9400",
            "fax_number": "906-483-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MEM DR",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499312492",
            "telephone_number": "906-482-9400",
            "fax_number": "906-483-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDER",
        "first_name": "LISA",
        "middle_name": "MARY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-11",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704371872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SKAGGS",
            "middle_name": "MARY",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gary Alan Moberg, D.D.S.
• Anna Mooi, RDN
• Janet Moran
• C. Michelle Morgan, M.D.
• Gabrielle Rain Mukavetz
• Beth A Mull, OT
• Gail Ann Neufeld, OTL
• Katherine Nordeng-Hoel, R.N.
• Bella Luisa Nutini, PA-C
• Erin Bray Nuttall, ATC, PTA

• Psychiatric/Mental Health Registered Nurse in Houghton, MI
• Providers in Houghton, MI by specialty
• Psychiatric/Mental Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2022; 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.