Gail Ann Lis, APRN BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4704132475 Issued in MI

Practice address

16010 19 Mile Rd
Suite 101
Clinton TWP, MI 48038-1141

Phone

(586) 286-8674

Fax

(586) 286-5564

NPI assigned

Dec 27, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: glis241509@direct.hfhs.org

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639235682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48748 DELMONT DR",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483742767",
            "telephone_number": "248-380-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16010 19 MILE RD",
            "address_2": "SUITE 101",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381141",
            "telephone_number": "586-286-8674",
            "fax_number": "586-286-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIS",
        "first_name": "GAIL",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "APRN BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704132475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "50-0-86-6974-0",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Acute Care Nurse Practitioner in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Acute Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.